Which of the following is a sign of pericardial tamponade?

• A. Clear breath sounds
• B. Muffled heart tones
• C. Rapid, bounding pulse
• D. Normal blood pressure

Answer: (B)

Muffled heart tones occur because fluid or blood in the pericardial sac surrounds and cushions the heart, dampening the sounds heard with a stethoscope. In pericardial tamponade, this compression reduces the heart’s ability to fill and eject blood, leading to decreased cardiac output and often hypotension. That combination makes muffled heart sounds a classic sign.

Other options don’t fit as well: clear breath sounds don’t indicate heart compression and point more to lung pathology; normal blood pressure would be unlikely since tamponade typically lowers cardiac output; a rapid, bounding pulse is not typical— tamponade usually presents with tachycardia and a weaker pulse due to reduced stroke volume.