 Let's finish up by discussing cardiac tamponade. So what is cardiac tamponade? This is the compression of the heart by fluid. It's going to decrease the cardiac output because it's going to decrease the ability of the heart to Relax and take in more blood and then pump that out. So our cardiac output will decrease with a cardiac tamponade. As you've seen this picture here, what is happening is the pericardial space or that sac that surrounds the heart is Filling up with fluid. What can that fluid be? It could be blood. It could be effusions We most commonly see this in some sort of a heart injury where it fills with blood a Characteristic of cardiac tamponade is that all four chambers of the heart have equal diastolic pressures Findings include Bex Triad. Bex Triad is characterized by hypotension Distended neck veins and distant heart sounds We can also see in cardiac tamponade an increase in heart rate pulses paradoxes and We'll discuss that here in just a minute Our ECG will show low voltage QRS and electrical alternance So what is pulses paradoxes pulse as paradoxes is a decrease in the amplitude of our systolic blood pressure By more than 10 milligrams of mercury during inspiration So if our normal resting systolic blood pressure is 120 Upon inspiration with someone that has a cardiac tamponade They'll they're increased in their blood pressure their systolic blood pressure will go up to at least 130 if not more when they inspire There is a mnemonic that we can use for cardiac tamponade to know what can cause this pulses paradoxes Peacote is the mnemonic So pulses paradoxes can be caused by Constrictive pericarditis and other obstructive pulmonary diseases such as croup OSA or obstructive sleep apnea asthma COPD which is not part of peacote and then the T finally is a cardiac tamponade so pulses paradoxes is Caused by pericarditis croup obstructive sleep apnea asthma and tamponade