Changes

* Right-sided congestive heart failure: jugular venous distension, jugular pulses, ascites, pleural effusion

* Right-sided congestive heart failure: jugular venous distension, jugular pulses, ascites, pleural effusion

* Weak pulses due to poor cardiac output

* Weak pulses due to poor cardiac output

* '''Pulsus paradoxicus''' (pulse quality varies excessively with respiration)

* '''Pulsus paradoxicus''' (pulse quality varies excessively with respiration). During inspiration, the normal negative thoracic pressure is transmitted to the pericardium and right atrium. This results in better right atrial and right ventricular filling during inspiration and shifts the interventricular septum toward the left ventricle. However, because the degree of cardiac distension is limited by the pericardial effusion, left ventricular filling is decreased with a resultant reduction in stroke volume during the next cardiac cycle. Therefore, the pulse is weak during inspiration and strong during expiration.

* Sinus tachycardia, compensatory mechanism for reduced cardiac output in order to maintain systemic blood pressure

* Sinus tachycardia, compensatory mechanism for reduced cardiac output in order to maintain systemic blood pressure