The fall in arterial blood pressure results from pericardial fluid accumulation inside the pericardial sac, which decreases the maximum size of the ventricles. This limits diastolic expansion (filling) which results in a lower EDV (End Diastolic Volume) which reduces stroke volume, a major determinant of systolic blood pressure. This is in accordance with the Frank-Starling law of the heart, which explains that as the ventricles fill with larger volumes of blood, they stretch further, and their contractile force increases, thus causing a related increase in systolic blood pressure. The rising central venous pressure is evidenced by distended jugular veins while in a non-supine position. It is caused by reduced diastolic filling of the right ventricle, due to pressure from the adjacent expanding pericardial sac. This results in a backup of fluid into the veins draining into the heart, most notably, the jugular veins. In severe hypovolemia, the neck veins may not be distended. The suppressed heart sounds occur due to the muffling effects of the fluid surrounding the heart.
Beck's triad 
types of Mood disorder
Onsan illness
medical cause of Insomnia
symptom of Bipolar disorder
symptom of Conversion disorder
Bell's mania
medical cause of Conversion disorder