UMEM Educational Pearls

Category: Cardiology

Title: JVD + hypotension + clear lungs

Keywords: right ventricular infarction, tamponade, tension pneumothorax, pulmonary embolism (PubMed Search)

Posted: 7/3/2011 by Amal Mattu, MD (Updated: 1/26/2022)
Click here to contact Amal Mattu, MD

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

References