This page is dedicated to organizing various examples of standardized exam questions whose answer is pericardial tamponade. While this may seem a odd practice, it is useful to see multiple examples of how pericardial tamponade will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
Question # 1
A 25 year old male arrives to the hospital with multiple guns shot wounds to the chest and abdomen. He is cold, shivering, anxious, and asks for a blanket and a drink of water. His blood pressure is 65/40. His pulse rate is 145 and is barely perceptible. He has big distended veins in his neck and forehead. He is breathing OK and has bilateral breath sounds and no tracheal deviation.
Explanation: gunshot wounds to chest + distended veins in neck/forehead + no tracheal deviation/absent breath sounds (i.e. no pneumothorax) = pericardial tamponade
A 25 year old male is brought to the ER after being involved in a motor vehicle accident. He was found unresponsive at the scene of the accident and was intubated but the paramedics. He received 2L of NS over the past half hour. His blood pressure is 85/40 mm Hg, and pulse is 115/min. He is responsive to vocal and tactical stimuli by opening his eyes. His neck veins are distended, and there are multiple bruises involving the anterior chest and the upper abdomen. His chest X-ray shows a small, left sided pleural effusion and normal cardiac contours. What is the likely diagnosis?
Explanation: trauma to chest + distended veins in neck/forehead + no tracheal deviation/absent breath sounds (i.e. no pneumothorax) + hypotension despite replacement of fluids = pericardial tamponade
A 23 year old gang member is brought to the ER after being he victim of a stabbing. Upon arrival his vitals are a temperature of 98.7°F, blood pressure of 70/45 mm Hg, heart rate of 115 ppm, and respiration’s of 24/min. He is diaphoretic and in clear distress. There are multiple lacerations over his chest, arms, and legs. He is bleeding form a penetrating injury right under his rib cage. A physical reveals normal lung sounds, however his heart sounds are distant and there is jugular venous distention. What is the likely diagnosis in this patient?
Explanation: trauma to chest + distended veins in neck/forehead + no tracheal deviation/absent breath sounds (i.e. no pneumothorax) = pericardial tamponade
Page Updated: 03.06.2017