This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Unknown
In patients who present with a penetrating chest injury, injury to the heart is most likely when the following physical sign(s) is/are present: 
Select and explain. 
A. Hypotension, B. Distended neck veins., C. Decreased heart sound., D. Decreased venous pressure
D: Decreased venous pressure
Answer: D: Decreased venous pressure 
Explanation: Hypotension, increased venous pressure (distended neck veins), and decreased heart sounds make up the classic Beck's triad associated with cardiac tamponade. If these three findings are present in a person who has a penetrating chest wound, intracardiac injury is almost certain and operative intervention is mandatory.