DDx for JVD + hypotension + clear lungs: RV infarction massive PE tension PTX (clear lung) pericardial tamponade
Assuming your physical exam diagnoses tension PTX, you only need two simple tests to make the diagnosis amongst the other possibilities: 1. EKG: RV infarction will almost always show a concurrent inferior MI; 2. bedside U/S: tamponade patients have effusion, PE patients have RV distension
