Pericardial tamponade produces Beck's triad: hypotension, jugular-venous distention, and muffled (distant) heart sounds. The insulating layer of pericardial fluid dampens acoustic transmission, so muffled heart sounds are a hallmark of tamponade-related obstructive shock. In cardiogenic shock, crackles and an S3 may be heard because of left-sided heart failure, and pulmonary capillary wedge pressure is typically elevated, but heart sounds are not characteristically muffled.
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Cardiovascular Emergencies
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