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: 12/6/2023)
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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