Which triad is classically observed in cardiac tamponade?

• A. JVD, muffled heart sounds, hypotension
• B. Chest pain, ST elevations, fever
• C. Murmur of aortic stenosis
• D. Palpitations, tachycardia, hypertension

Answer: (A)

The key idea is Beck’s triad, the classic set of signs seen with cardiac tamponade: distended neck veins (elevated venous pressure), muffled heart sounds, and low blood pressure from reduced cardiac filling. When fluid accumulates in the pericardial space, it raises intrapericardial pressure and restricts the heart’s diastolic filling. That drop in filling lowers stroke volume and cardiac output, causing hypotension. The restricted filling also backs up venous pressure, producing JVD, while the surrounding fluid dampens the heart sounds, making them muffled. Pulsus paradoxus may also be detected, and ECG might show electrical alternans, but the triad of JVD, muffled heart sounds, and hypotension is the classic clue for tamponade. The other options point to different conditions—chest pain with ST elevations and fever suggests pericarditis or MI; a murmur of aortic stenosis indicates valvular disease; and palpitations with tachycardia and hypertension don’t specifically reflect tamponade physiology.