A 25-year-old woman was stabbed by her boyfriend in the left chest. On examination, she has a 1-cm stab wound just inferior to her left breast in the mid-clavicular line. There is jugular venous distension and breath sounds are completely absent on the left side. She is becoming extremely dyspneic and hypoxic.: (A) Tension pneumothorax, (B) Cardiac tamponade, (C) Spontaneous pneumothorax, (D) Open pneumothorax
Answer is A. Precordial stab wound distended jugular veins, and hypotension should suggest a cardiac tamponade. It must be kept in mind that the same signs are those of a tension pneumothorax. Dyspnea and deviation of trachea to the opposite side, absent breath sounds, and hyperresonant percussion note should suggest the correct diagnosis.