Sinus tachycardia

Elevated jugular venous pressure

Pulsus paradoxus

  • Echo
    • Collapse of the right atrium at end-diastole
      • At end-diastole (during atrial relaxation), the RA volume is minimal, but pericardial pressure is maximal, causing the RA to buckle
    • Collapse of the right ventricle in early diastole
      • less sensitive for the presence of cardiac tamponade than RA
      • occurs in early diastole when the RV volume is still low.
        • may not be present when the RV is hypertrophied  diastolic pressure is significantly  elevated
          • collapse of any cardiac chamber, but usually the right sided chambers, oes are only slightly exceeded by those in the pericardium
      • From Up to Date
        Collapse of the right atrium and right ventricle in diastole

        From Up to Date
        Slit like of right ventricle in diastole
    • Reciprocal changes in left and right ventricular volumes with respiration, which are important in the pathogenesis of pulsus paradoxus
    • IVC
      • IVC >20mm
      • On inspiration stays the same – Should decrease with inspiration by about 50%
  • CT
  • distention of the
    • venae cavae and hepatic veins,
    • deformity cardiac chambers,
    • bowing of the interventricular septum, and
    • reflux of contrast into the azygos vein and inferior vena cava
      • ? coronary sinus compression on CT is an early specific indicator
      • ?right ventricular wall flattening