Quote from 2mochas
A speaker for a CCRN review class told us it was a good idea to be able to tell the difference between cardiac tamponade and tension pneumothorax. I am finding conflicting information....anyone know?
Both are forms of obstructive shock and result in elevated filling pressures (CVP, PAP) and cardiogenic shock (low CO). They also are seen under similar circumstances (trauma, cardiac surgery, etc)
PTX is far easier to diagnosis by physical exam than tanponade. With true tension you should have absent or severely diminished breath sounds and the things mentioned above (tracheal shift, dyssynchronous chest wall motion). It's pretty obvious and easy to relieve with a needle compression.
Tamponade (in my experience) can lack the hallmark features you read about such as tachycardia or muffled heart tones. Unless the clinical situation makes it obvious (surgery, cath lab procedure, certain traumas), you need a CXR at minumim and echo to rule in/out.