Patients with catastrophic cardiovascular conditions often manifest with JVD + hypotension. The DDx for this combination is therefore critical to know:
large LV MI
right ventricular MI
cardiac tamponade
tension PTX
massive PE
acute mitral regurgitation
acute aortic regurgitation
You can make a diagnosis clinically among these 7 entities by:
Listening to the lungs
Listening for murmurs
Getting an ECG.
Of course if you have bedside U/S, it becomes even easier. ECG is almost always diagnostic with either the large LV MI or RV MI. Wet lungs found in large LV MI, acute MR, and acute AR. Murmur found in MR (systolic) and AR (diastolic).
