Which finding is most consistent with pericardial tamponade in a trauma patient?

• A. Hyperresonant chest
• B. Diminished breath sounds
• C. JVD
• D. Clear lungs

Answer: (C)

Blood accumulating in the pericardial sac after trauma raises pressure around the heart and prevents proper filling, which lowers preload and cardiac output. That pressure backs up into the venous system, most evident as distention of the neck veins (jugular venous distension). This neck vein finding is a classic clue that points to tamponade in a trauma patient. Lungs may be clear or only mildly involved, and muffled heart sounds can occur from the surrounding fluid, but the standout sign here is the distended neck veins. In contrast, a hyperresonant chest or diminished breath sounds typically signals chest injuries like pneumothorax or hemothorax rather than tamponade.