JBL Trauma Practice Test 2025 - Free Trauma Practice Questions and Study Guide

When a patient with a chest injury presents with narrowing pulse pressure and jugular venous distention, pericardial tamponade should be suspected. This condition occurs when fluid accumulates in the pericardial sac, exerting pressure on the heart and impairing its ability to fill properly during diastole. The narrowing pulse pressure is a critical clinical sign indicating that the systolic blood pressure is falling or the diastolic is rising, leading to a reduced difference between the two. In pericardial tamponade, the heart is unable to generate effective stroke volume due to the external pressure, which can manifest as hypotension and compensatory changes such as an increased heart rate.

Jugular venous distention occurs as the elevated pressure in the thoracic cavity prevents proper venous return to the heart, causing venous congestion. When both of these signs are present, it strongly indicates that pericardial tamponade is the underlying issue. This condition is particularly important to identify quickly, as it requires urgent intervention, typically in the form of pericardiocentesis or surgical drainage, to relieve the pressure on the heart and restore hemodynamic stability.