# The heart sounds demonstrate a ______ rhythm, with regular variation in intensity during respiration, typical of cardiac tamponade.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168428  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The heart sounds demonstrate a ______ rhythm, with regular variation in intensity during respiration, typical of cardiac tamponade.

## 보기

1. pulsus **✔ 정답**
2. alternating
3. galloping
4. regular
5. varying

**정답: 1**

## 해설

Pulsus paradoxus, a regular variation in pulse intensity with respiration where systolic pressure falls more than 10 mmHg during inspiration, is a classic finding in cardiac tamponade. This represents enhanced ventricular interdependence due to pericardial compression.

## 임상 시나리오

Key Points about Cardiac Tamponade:

1. Definition
- Compression of heart by fluid in pericardial space
- Life-threatening condition requiring immediate treatment

2. Clinical Features
- Beck's triad: hypotension, JVD, muffled heart sounds
- Pulsus paradoxus >10 mmHg
- Tachycardia
- Electrical alternans on ECG

3. Hemodynamic Changes
- Decreased cardiac output
- Increased central venous pressure
- Equalization of diastolic pressures

4. Common Causes
- Pericardial effusion
- Trauma
- Malignancy
- Post-cardiac surgery
- Infection

5. Diagnostic Methods
- Echocardiography
- Cardiac CT
- Right heart catheterization
- Chest X-ray

6. Treatment Options
- Pericardiocentesis
- Surgical pericardiectomy
- Treatment of underlying cause
- Volume resuscitation

## 핵심 개념

- **pulsus** — A rhythmic beating or throbbing, especially referring to arterial pulsation or heartbeat
- **alternating** — Occurring or changing by turns; following one after another in succession
- **galloping** — A three-beat heart rhythm that sounds similar to a horse's gallop, often indicating heart failure
- **regular** — Occurring at fixed intervals; having a constant or definite pattern
- **varying** — Changing or differing from one instance to another; not remaining constant

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