Tamponade: time the collapse

Question 1Which timing best supports right ventricular collapse from tamponade?

1. aAny phase is equally useful
2. bEarly diastole
3. cLate systole
4. dAtrial systole only

Question 2Why is a brief right atrial flicker not enough on its own?

1. aThe right atrium never collapses in tamponade
2. bOnly the left atrium matters
3. cCollapse lasting through a good part of systole is what makes the sign more specific
4. dTiming is irrelevant to the sign

Question 3Which state can make right-sided collapse appear earlier?

1. aA stiff right ventricle
2. bA high right atrial pressure
3. cSevere pulmonary hypertension
4. dHypovolaemia

Question 4Can a full IVC alone diagnose tamponade?

1. aNo. It is sensitive but not specific, so it must be read with the rest of the scan and the patient
2. bYes, in every ventilated patient
3. cYes, if the effusion is small
4. dNo, because the IVC is never relevant

Question 5A hypotensive patient has a pericardial effusion and right ventricular collapse in early diastole. What do you do?

1. aEscalate urgently for senior and procedural help while you complete the assessment
2. bWait for a formal echocardiogram before telling anyone
3. cIgnore the scan because tamponade is a clinical diagnosis
4. dMeasure the effusion and discharge if it is under 2 cm