In acute pericarditis, which of the following is a serious complication that requires careful monitoring to prevent progression to tamponade?

• A. Pericardial effusion
• B. Aortic dissection
• C. Myxedema
• D. Chylopericardium

Answer: (A)

The main idea is that fluid accumulating in the pericardial sac during acute pericarditis can become a life-threatening problem if it compresses the heart. A pericardial effusion, especially if it’s large or develops rapidly, can raise intrapericardial pressure enough to prevent the heart from filling properly during diastole. This produces cardiac tamponade, where reduced ventricular filling leads to decreased stroke volume and cardiac output, causing hypotension and signs of poor perfusion if not promptly addressed. That’s why monitoring for evolving effusion with imaging and watching for symptoms or hemodynamic changes is essential in acute pericarditis. When tamponade occurs or is imminent, urgent relief with pericardiocentesis or another drainage procedure is required, alongside continuing management of the underlying inflammation. The other listed conditions don’t represent typical progression from acute pericarditis and are not the mechanism by which tamponade develops.