Cardiovascular · UKMLA & AKT
Cardiac tamponade
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise cardiac tamponade — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Beck's triad - hypotension + raised JVP + muffled heart sounds (all three present together in only a minority of cases)
- Pulsus paradoxus - exaggerated fall in systolic BP (>10 mmHg) during normal inspiration; hallmark sign of tamponade
- Tachycardia - early compensatory response to falling stroke volume
- Hypotension - late and ominous, indicates decompensation
- Raised JVP - venous back-pressure from impaired right heart filling
- Dyspnoea - most common symptom
- Kussmaul's sign is ABSENT - JVP rises on inspiration in constrictive pericarditis but NOT in tamponade; key differentiating feature
Pulsus paradoxus mechanism: inspiration causes right ventricle to fill preferentially; in tamponade, RV expansion shifts the interventricular septum leftwards (ventricular interdependence), reducing LV filling and stroke volume - systolic BP falls >10 mmHg. The two ventricles compete for space inside a non-compliant sac.
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