A 31-year-old man presents to the emergency department after a stab wound to the left anterior chest. He is confused and diaphoretic with BP 82/56 mm Hg, HR 118/min, RR 24/min, and distended jugular veins. Heart sounds are muffled and distant. Chest X-ray shows a widened mediastinum. Breath sounds are present bilaterally. Which of the following additional findings is most likely?

  1. A)Wide pulse pressure
  2. B)Bounding carotid pulses
  3. C)An S4 gallop
  4. D)Pulsus paradoxusGABARITO
  5. E)Fixed split S2

Explicação

Pulsus paradoxus is correct. Cardiac tamponade restricts ventricular filling and causes an exaggerated fall in systolic blood pressure during inspiration. The combination of hypotension, jugular venous distention, and muffled heart sounds is Beck triad. Ver explicação completa e trilha adaptativa →

Fazer o diagnóstico grátis de USMLE