A 24-year-old man is brought to the emergency department 15 minutes after he sustained a stab wound to the left chest. On arrival, he has rapid, shallow breathing and appears anxious. His pulse is 135/min, respirations are 30/min and shallow, and palpable systolic blood pressure is 80 mm Hg. Examination shows no active external bleeding. There is a 2.5-cm single stab wound to the left chest at the 4th intercostal space at the midclavicular line. Cardiovascular examination shows muffled heart sounds and jugular venous distention. Breath sounds are normal. Which of the following hemodynamic changes are most likely present in this patient due to his current cardiac condition?

Question

A 24-year-old man is brought to the emergency department 15 minutes after he sustained a stab wound to the left chest. On arrival, he has rapid, shallow breathing and appears anxious. His pulse is 135/min, respirations are 30/min and shallow, and palpable systolic blood pressure is 80 mm Hg. Examination shows no active external bleeding. There is a 2.5-cm single stab wound to the left chest at the 4th intercostal space at the midclavicular line. Cardiovascular examination shows muffled heart sounds and jugular venous distention. Breath sounds are normal.   Which of the following hemodynamic changes are most likely present in this patient due to his current cardiac condition?

Quizplus · Accepted Answer

Eductional Objective: Cardiac tamponade involves increased pericardial pressure that restricts diastolic filling of the right-sided heart chambers, leading to obstructive shock with increased central venous pressure and decreased stroke volume and cardiac output.  As tamponade progresses, diastolic pressures in all 4 cardiac chambers increase and equalize with pericardial pressure (and with one another), stagnating blood flow within the heart.

A 24-Year-Old Man Is Brought to the Emergency Department 15