How is cardiac tamponade treated?

• A. Volume expansion and pericardiocentesis or emergency sternotomy
• B. Antibiotics
• C. Diuretics
• D. ACE inhibitors

Answer: (C)

Cardiac tamponade is a life-threatening situation where fluid in the pericardial sac compresses the heart and prevents it from filling properly, leading to decreased cardiac output. The key treatment is to relieve that pressure by draining the fluid. This is done urgently with pericardiocentesis, and if that cannot be done quickly or if there is ongoing bleeding, emergency sternotomy to access and drain the pericardium is needed. Giving IV fluids to expand the circulating volume can briefly help by increasing preload, but it is not a definitive solution and does not remove the cause of the tamponade. The other options don’t address the mechanical compression: antibiotics target infection, diuretics reduce preload and would worsen the situation, and ACE inhibitors aren’t used to treat tamponade.