Cardiac tamponade Clinically. Note hypotension, juglar venous distension, muffled heart sounds, pulsus paradoxus. Normally, systolic pressure drops less than 10 mm Hg on inspiration. Decide on systolic pressure when patient has exhaled. Next have the patient inhale and determine the difference between the two systolic pressures.
Treatment is rapid fluid infusion, pericardiocentesis.
Myocardial contusion defined as blunt trauma to the heart. Best diagnostic tests are echocardiography, first-pass biventricular angiography. Best approach is to simply monitor the hemodynamically stable patient. Usually the only clinical problem is episodes of PSVT or self-limited ventricular tachycardia. From deceleration injury.