What are the key clinical signs and symptoms that suggest cardiac tamponade in a primary care setting?

Key clinical signs and symptoms suggesting cardiac tamponade in a primary care setting include:

• Dyspnoea and tachypnoea: Patients often present with shortness of breath due to impaired cardiac filling and reduced cardiac output ¹ (Kearns and Walley, 2018).
• Chest discomfort or pain: This may be vague or pleuritic, reflecting pericardial irritation or pressure effects ¹ (Kearns and Walley, 2018).
• Hypotension and tachycardia: Compensatory tachycardia and low blood pressure are common due to reduced stroke volume and cardiac output ¹ (Kearns and Walley, 2018).
• Elevated jugular venous pressure (JVP): Raised JVP is a key clinical sign indicating impaired right heart filling and venous congestion ¹ (Kearns and Walley, 2018).
• Muffled or distant heart sounds: Pericardial fluid dampens heart sounds, making them quieter on auscultation ¹ (Kearns and Walley, 2018).
• Pulsus paradoxus: An exaggerated decrease in systolic blood pressure during inspiration (>10 mmHg) is a classic but sometimes subtle sign ¹ (Kearns and Walley, 2018).
• Signs of shock or poor peripheral perfusion: Cold extremities, clammy skin, and confusion may be present in advanced tamponade ¹ (Kearns and Walley, 2018).

In primary care, these signs and symptoms should prompt urgent referral for echocardiography and specialist assessment, as tamponade is a medical emergency ¹ (Kearns and Walley, 2018).