Patient 1:

This is a previously healthy young woman who was admitted to the hospital with increasing dyspnea and fatigue, and was found to have cardiac tamponade. The first video was recorded immediately prior to pericardiocentesis. Notice the elevated jugular venous pressure (patient is in the upright position) with a single descent. If properly timed with the cardiac cycle, the single trough of the jugular venous waveform of cardiac tamponade is the x descent. The second video was recorded immediately following pericardiocentesis, during which 500 ccs of chylous fluid was evacuated. Notice the low jugular venous pressure (patient is in the Trendelenburg position) with the return of two troughs.