Which signs suggest acute pericardial tamponade after catheterization?

• A. Hypotension, tachycardia, muffled heart sounds, jugular venous distension
• B. Hypertension, bradycardia
• C. Normal heart sounds, no JVD
• D. Fever and leukocytosis

Answer: (A)

Acute pericardial tamponade after catheterization happens when blood or fluid quickly accumulates in the pericardial space, compressing the heart and impairing filling. The falling stroke volume leads to low blood pressure, and the body responds with a fast heart rate, so tachycardia is common. The fluid around the heart muffles the heart sounds, making them harder to hear, and the elevated pressure in the chest reduces venous return, causing jugular venous distension as blood backs up in the neck veins. Pulsus paradoxus may also be present, reflecting exaggerated fall in systolic blood pressure during inspiration.

This combination—hypotension, tachycardia, muffled heart sounds, and jugular venous distension—best fits tamponade after a procedure.

Hypertension with bradycardia wouldn’t match tamponade physiology. Normal heart sounds with no JVD suggests no pericardial effusion. Fever and leukocytosis point more toward infection or inflammation rather than acute tamponade.