A 45-year-old male is involved in a high-speed motor vehicle collision and presents with signs of hypovolemic shock, distended neck veins, and pulsus paradoxus. What is the most likely diagnosis?
Aortic dissection
Hemothorax
Cardiac tamponade
Tension pneumothorax
The patient's presentation, including signs of hypovolemic shock, distended neck veins, and pulsus paradoxus, is consistent with cardiac tamponade. In traumatic settings, a great vessel injury can result in pericardial effusion leading to tamponade. Hypovolemic shock is due to decreased cardiac output, distended neck veins are from increased venous pressure, and pulsus paradoxus is a hallmark of cardiac tamponade. Other options such as tension pneumothorax or aortic dissection may have overlapping features but typically present differently in terms of symptoms and physical findings.
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