In cardiac tamponade, which of the following is an emergent management step?

• A. Emergent cardiology consult
• B. IV fluid bolus
• C. Pericardiocentesis
• D. Admit to ICU

Answer: (C)

When the pericardial space fills and compresses the heart, the ventricles can’t fill properly, causing a rapid drop in cardiac output. The fastest, life-saving move is to relieve that pressure by draining the pericardial sac—pericardiocentesis. This decompresses the heart, restores diastolic filling, and improves blood pressure within minutes, which is why it is the emergent management in tamponade.

Emergent cardiology involvement is important, but it doesn’t immediately treat the mechanical compression. An IV fluid bolus might temporarily support perfusion in a shock picture, but it does not relieve the tamponade and can carry risks by increasing venous pressures. ICU admission is a later consideration after stabilization, not the immediate life-saving step.