Which sign is classically associated with cardiac tamponade?

Which sign is classically associated with cardiac tamponade?

• A. Pulsus paradoxus
• B. Hyperreflexia
• C. Decreased JVP
• D. Elevated liver enzymes

Answer: (A)

Pulsus paradoxus is the sign most classically linked to cardiac tamponade. In tamponade, fluid in the pericardial sac restricts the heart’s ability to fill, so during inspiration the increased return to the right heart further shifts the interventricular septum toward the left ventricle. That reduces left ventricular stroke volume and causes a fall in systolic blood pressure with inspiration—often more than 10 mmHg. This exaggerated inspiratory BP drop is the pulsus paradoxus. Beck’s triad—hypotension, elevated jugular venous pressure, and muffled heart sounds—can also be present in tamponade, reinforcing the diagnosis. It’s worth noting that decreased JVP would not fit tamponade, and the other options aren’t signs of this condition.

Pulsus paradoxus is the sign most classically linked to cardiac tamponade. In tamponade, fluid in the pericardial sac restricts the heart’s ability to fill, so during inspiration the increased return to the right heart further shifts the interventricular septum toward the left ventricle. That reduces left ventricular stroke volume and causes a fall in systolic blood pressure with inspiration—often more than 10 mmHg. This exaggerated inspiratory BP drop is the pulsus paradoxus.

Beck’s triad—hypotension, elevated jugular venous pressure, and muffled heart sounds—can also be present in tamponade, reinforcing the diagnosis. It’s worth noting that decreased JVP would not fit tamponade, and the other options aren’t signs of this condition.