The nurse is assigned to a patient who is suffering from acute pericarditis. The patient suddenly becomes hypotensive with signs of peripheral vascular insufficiency. On exam, the patient has significant jugular venous distention and muffled heart sounds. Which statement best describes the pathophysiology of this patient’s condition?

Question

The nurse is assigned to a patient who is suffering from acute pericarditis.  The patient suddenly becomes hypotensive with signs of peripheral vascular insufficiency.  On exam, the patient has significant jugular venous distention and muffled heart sounds.  Which statement best describes the pathophysiology of this patient&rsquo;s condition?

Accepted Answer

Rapid accumulation of fluid in the pericardial space is compressing the heart. Patients who have acute pericarditis are at risk for developing cardiac tamponade if the accumulation of fluid in the pericardial space is too rapid.  Cardiac tamponade results in cardiogenic shock secondary to compression of the heart by the pericardial fluid.  The recommended treatment is immediate pericardiocentesis to remove the fluid collection.  An infectious process causing myocardial dysfunction describes infectious cardiomyopathy, which would present with symptoms such as fever and elevated WBC.  Dilation of the left ventricle refers to dilated cardiomyopathy, which typically develops along a more chronic course and would not present acutely like this.  Pulmonary hypertension resulting in right heart failure would present acutely with JVD but would also typically have dyspnea and signs of pulmonary edema or vascular congestion.

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