What is the classic triad of signs in cardiac tamponade?

• A. Hypotension, muffled heart sounds, JVD
• B. Hypertension, loud S1, tachycardia
• C. Hypotension, hyperactive bowel sounds, fever
• D. JVD, edema, crackles

Answer: (A)

Tamponade occurs when fluid accumulates in the pericardial space, raising intrapericardial pressure and preventing the heart from filling properly during diastole. This drop in filling reduces stroke volume and cardiac output, producing low blood pressure. The signs that best reflect this situation are the triad: hypotension from decreased cardiac output, muffled heart sounds because the fluid around the heart dampens the sounds heard with a stethoscope, and distended neck veins from elevated central venous pressure as venous return backs up. A pulsus paradoxus may also be present, reinforcing the sense that filling is being impeded.

Other options describe signs more typical of different conditions. Hypertension with a loud S1 points to valve or hypertensive issues rather than tamponade. Hypotension with hyperactive bowel sounds and fever fits abdominal or infectious processes rather than cardiac tamponade. JVD with edema and crackles aligns more with heart failure/fluid overload, not the specific filling impairment seen in tamponade.