NREMT Paramedic Practice

Which of the following is a common symptom of pericardial tamponade?

1. Cyanosis of the extremities

2. Pulsus paradoxus

3. Elevated heart rate

4. Decreased blood pressure

The correct answer is: Pulsus paradoxus

Pulsus paradoxus is a common symptom of pericardial tamponade, characterized by a notable drop in blood pressure during inspiration. This phenomenon occurs when the heart is encased in fluid (as in pericardial tamponade), limiting its ability to expand fully and leading to changes in hemodynamics during the respiratory cycle. During inspiration, the increased venous return to the heart causes a larger drop in pressure than normal when the pericardial sac is compressed by excess fluid. As a result, the pulse pressure (the difference between systolic and diastolic blood pressure) decreases more than usual, which is observed as a significant decrease in systolic blood pressure. Other symptoms of pericardial tamponade may include elevated heart rate and decreased blood pressure but are not as specific or distinctive as pulsus paradoxus for diagnosing this condition. Cyanosis of the extremities can occur in various respiratory or circulatory conditions but is not a hallmark sign of pericardial tamponade. Thus, pulsus paradoxus is particularly valuable in clinical assessments of patients suspected of having this condition.