Rosh Emergency Medicine Practice Test

What vital sign finding is atypical in a case of cardiac tamponade?

1. Hypotension

2. Tachycardia

3. Bradycardia

4. Jugular venous distention

The correct answer is: Bradycardia

In the setting of cardiac tamponade, bradycardia is considered atypical because the expected physiological response to hypotension—which is commonly present due to the compromised filling of the heart—would typically be an increase in heart rate (tachycardia). The body responds to reduced cardiac output by activating compensatory mechanisms, one of which includes an increase in heart rate to improve circulation. Cardiac tamponade leads to decreased stroke volume and can result in hypotension, which is indeed common. Elevated jugular venous pressure, reflected by jugular venous distention, also commonly occurs due to impaired filling of the heart and fluid backup into the venous system. Therefore, while hypotension, tachycardia, and jugular venous distention are all typical findings associated with cardiac tamponade, bradycardia does not typically align with the compensatory responses observed in this condition.