A 32-year-old man comes to the emergency department because of sharp chest pain for 3 days. The pain is retrosternal, 8 out of 10 in intensity, increases with respiration, and decreases while sitting upright and leaning forward. He has nausea and myalgia. He has not had fever or a cough. He has asthma and was treated for bronchitis 6 months ago with azithromycin. His mother has hypertension. He uses an over-the-counter inhaler. His temperature is 37.3°C (99.1°F), pulse is 110/min, and blood pressure is 130/84 mm Hg. Breath sounds are normal, but the jugular veins are distended. His pulse becomes undetectable to palpation during inspiration.An ECG shows diffuse ST elevations in all leads. The patient is at increased risk for which of the following conditions?

Question

A 32-year-old man comes to the emergency department because of sharp chest pain for 3 days. The pain is retrosternal, 8 out of 10 in intensity, increases with respiration, and decreases while sitting upright and leaning forward. He has nausea and myalgia. He has not had fever or a cough. He has asthma and was treated for bronchitis 6 months ago with azithromycin. His mother has hypertension. He uses an over-the-counter inhaler. His temperature is 37.3°C (99.1°F), pulse is 110/min, and blood pressure is 130/84 mm Hg. Breath sounds are normal, but the jugular veins are distended. His pulse becomes undetectable to palpation during inspiration.An ECG shows diffuse ST elevations in all leads. The patient is at increased risk for which of the following conditions?

Quizplus · Accepted Answer

Eductional Objective: Cardiac tamponade typically presents with hypotension with pulsus paradoxus, elevated jugular venous pressure, and muffled heart sounds (Beck's triad).  Pulsus paradoxus refers to an abnormal exaggerated decrease in systolic blood pressure >10 mm Hg on inspiration, and is a common finding in patients with pericardial effusion with cardiac tamponade.

A 32-Year-Old Man Comes to the Emergency Department Because of Sharp