NREMT Paramedic Practice

What symptom might occur with pericardial tamponade but NOT with myocardial contusion?

1. Chest pain

2. Cyanosis of head and neck

3. Persistent tachycardia

4. Pericardial friction rub

The correct answer is: Cyanosis of head and neck

Pericardial tamponade is a condition where fluid accumulates in the pericardial space, exerting pressure on the heart and inhibiting its ability to pump effectively. One of the hallmark symptoms of this condition is the development of jugular venous distension and potential cyanosis, particularly in the head and neck area due to impaired venous return and decreased cardiac output. This symptom can arise as a result of elevated pressure in the superior vena cava, causing blood to pool and leading to cyanosis. In contrast, myocardial contusion typically results from direct injury to the myocardium, often seen in cases of blunt chest trauma. Symptoms associated with myocardial contusion, like chest pain, persistent tachycardia, and possibly a pericardial friction rub, are related more to the heart muscle's injury rather than the effects of fluid accumulation around the heart. While chest pain and tachycardia can be present as a response to injury, they do not specifically indicate the presence of pericardial tamponade, nor do they lead to distinct changes such as cyanosis in the head and neck area. Thus, cyanosis of the head and neck is a symptom that is more characteristic of pericardial tamponade due