A 56-year-old male presents to the emergency department with muffled heart sounds, hypotension, and jugular vein distention. The patient's blood pressure drops further during inspiration. Which of the following interventions is MOST appropriate for this patient?
Immediate pericardiocentesis
Continuous cardiac monitoring without intervention
The patient is displaying signs of Beck's triad (distant heart sounds, hypotension, and jugular vein distention) as well as pulsus paradoxus (drop in blood pressure during inspiration), which are classic signs of pericardial tamponade. This is a medical emergency that requires immediate intervention to prevent cardiovascular collapse. The best initial intervention is to perform a pericardiocentesis, which involves using a needle to aspirate fluid from the pericardial space to relieve pressure on the heart. Volume resuscitation may temporarily help manage hypotension but does not address the underlying issue, thus it is not the best option given the provided signs. Oxygen administration and cardiac monitoring are supportive measures but are not definitive treatments for tamponade.
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BCEN CEN
Cardiovascular Emergencies
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