Cardiac tamponade

Beck triad[46]Beck CS. Two cardiac compression triads. JAMA. 1935 Mar 2;104(9):714-6.​​

Hypotension, elevated jugular venous pressure (JVP), and distant heart sounds.

Most patients will not present with all of the classic features of the Beck triad (hypotension, distant heart sounds, and elevated JVP).[40]Roy CL, Minor MA, Brookhart MA, et al. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007 Apr 25;297(16):1810-8. http://www.ncbi.nlm.nih.gov/pubmed/17456823?tool=bestpractice.com [41]Stolz L, Valenzuela J, Situ-LaCasse E, et al. Clinical and historical features of emergency department patients with pericardial effusions. World J Emerg Med. 2017;8(1):29-33. https://pmc.ncbi.nlm.nih.gov/articles/PMC5263032 http://www.ncbi.nlm.nih.gov/pubmed/28123617?tool=bestpractice.com ​ One systematic review found that the sensitivities of hypotension and distant heart sounds were low, at 26% and 28%, respectively.[40]Roy CL, Minor MA, Brookhart MA, et al. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007 Apr 25;297(16):1810-8. http://www.ncbi.nlm.nih.gov/pubmed/17456823?tool=bestpractice.com ​ The most common physical exam findings of tamponade included: tachycardia, elevated JVP, and pulsus paradoxus (>10 mmHg drop in systolic blood pressure with inspiration), with pooled sensitives of 76% to 82%.