Cardiac tamponade physical examination

Physical Examination
Initial diagnosis can be challenging, as there are a number of differential diagnoses, including Tension pneumothorax, and acute heart failure.

Classical cardiac tamponade presents three signs, known as Beck's triad. Hypotension occurs because of decreased stroke volume, jugular venous distension due to impaired venous return to the heart, and muffled heart sounds due to fluid inside the pericardium Another sign of tamponade on physical examination includes pulsus paradoxus (a drop of at least 10 mmHg in arterial blood pressure on inspiration). There may also be general signs & symptoms of cardiogenic shock (such as tachycardia, breathlessness, poor perfusion of the extremities and decreasing level of consciousness). Peripheral edema may be present. Hemodynamic changes diminish S1 and S2. As Ventricular volume shrinks disproportionately, there may be psuedoprolapse/true prolapse of mitral and/or tricuspid valvular structures that result in clicks.