QuestionSBA
QuestionChoice
Transcatheter aortic valve insertion is one of the definitive management options for patients presenting with aortic stenosis. This would classically present with an ejection systolic murmur, dyspnoea on exertion, as well as angina symptoms.
10002319
c
Transcatheter aortic valve insertion (TAVI)
QuestionChoice
This patient is presenting with signs and symptoms suggestive of cardiac tamponade, particularly given the triad of muffled heart sounds, raised JVP and hypotension. Cardiac tamponade involves blood (or other fluid) accumulating in the pericardial space leading to reduced ventricular filling and reduced cardiac output. The emergency management for cardiac tamponade is pericardiocentesis, in which a needle is inserted into the pericardial space under ultrasound guidance to drain the excess fluid.
10002317
a
Pericardiocentesis
QuestionChoice
Balloon angioplasty involves a balloon being used to stretch open a narrowed coronary artery. This may be performed to improve coronary blood flow in patients with severe angina.
10002320
d
Balloon angioplasty
QuestionChoice
Percutaneous coronary intervention would be the definitive management for ST-elevation myocardial infarction (STEMI), as opposed to cardiac tamponade.
10002318
b
Percutaneous coronary intervention (PCI)
QuestionChoice
An endovascular aneurysm repair is a treatment option for abdominal aortic aneurysms (AAA), as opposed to cardiac tamponade. AAAs would typically present with hypotension, severe abdominal pain and a pulsatile abdominal mass.
10002321
e
Endovascular aneurysm repair (EVAR)
Concept
Chapter
2693
4032
Emergency Management of Cardiac Tamponade
Topic
134
Cardiology
13010
A 64-year-old male presents to the Emergency Department complaining of severe chest pain. He has a past medical history of myocardial infarction, hypertension and hypercholesterolaemia. His current medications include aspirin, clopidogrel, ramipril, bisoprolol and atorvastatin.

The patient's observations are as follows: heart rate 112 bpm regular, blood pressure 88/62 mmHg, respiratory rate 18 breaths/minute, SpO2 94% on air, temperature 37.6 degrees Celsius. Cardiovascular examination reveals muffled heart sounds and raised jugular venous pressure (JVP).

Given the most likely diagnosis, what is the definitive emergency management for this condition?
a