Which of the following is NOT a sign of cardiac tamponade?

• A. Hypotension
• B. Bounding pulses
• C. Muffled or distant heart tones
• D. JVD

Answer: (B)

The key idea is recognizing the pattern of hemodynamic collapse in cardiac tamponade. When fluid puts pressure on the heart, it prevents proper filling, so cardiac output drops. This typically causes hypotension, distended neck veins, and muffled heart sounds. A pulsus paradoxus—a greater-than-normal drop in systolic blood pressure during inspiration—often appears as well. Bounding pulses, on the other hand, reflect a high stroke volume or wide pulse pressure seen in other conditions like a hyperdynamic state or certain valvular diseases, not tamponade. So a strong, bounding pulse doesn’t fit the tamponade picture, where the pulses are usually weak due to reduced output.