In cardiac tamponade, which hemodynamic pattern is typically observed?

In cardiac tamponade, which hemodynamic pattern is typically observed?

• A. Increased right atrial pressure, increased PCWP, decreased CO, decreased MAP
• B. Decreased right atrial pressure, decreased PCWP, increased CO
• C. Increased CO and MAP with decreased afterload
• D. Decreased RA pressure and PCWP with increased SVR

Answer: (A)

In tamponade, extra pericardial fluid raises intrapericardial pressure and prevents normal diastolic filling of the heart. This back pressure backs up into the venous system, so right atrial pressures rise and left-sided filling pressure (reflected by the pulmonary capillary wedge pressure) also increases. Because the ventricles can’t fill adequately, stroke volume and cardiac output fall, leading to lowered mean arterial pressure. This combination—elevated filling pressures with reduced forward flow—is the hallmark of tamponade physiology.

In tamponade, extra pericardial fluid raises intrapericardial pressure and prevents normal diastolic filling of the heart. This back pressure backs up into the venous system, so right atrial pressures rise and left-sided filling pressure (reflected by the pulmonary capillary wedge pressure) also increases. Because the ventricles can’t fill adequately, stroke volume and cardiac output fall, leading to lowered mean arterial pressure. This combination—elevated filling pressures with reduced forward flow—is the hallmark of tamponade physiology.