A man brought into the ED after being stabbed in the chest. Chest is bilaterally clear with
muffled heart sounds. BP is 60/nil. Pulse is 120bpm. JVP raised. What is the most likely dx?
a. Pulmonary embolism
b. Cardiac tamponade
c. Pericardial effusion
d. Hemothorax
e. Pneumothorax
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answer B
• Beck’s triad: hypotension,
distended neck veins, muffled
heart sounds
• Tachycardia, tachypnea
• Pulsus paradoxus
• Kussmaul’s sign (increased
JVP with inspiration)
inv
• Echocardiogram
• FAST
ttt
• IV fluids
• Pericardiocentesis
• Open thoracotomy
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