Which clinical finding is indicative of pericardial tamponade?

Muffled heart sounds are a classic clinical finding associated with pericardial tamponade. This condition occurs when fluid accumulates in the pericardial sac, leading to increased pressure on the heart. As a result, the heart has a diminished ability to expand and fill properly, which is reflected in the muffled or distant sounds upon auscultation. This finding is often described using the triad of signs known as Beck's triad, which includes hypotension, distended neck veins, and muffled heart sounds. It underscores the essential point that the accumulation of fluid leads to a more challenging examination of the heart sounds, indicating that the heart's normal function and sounds are altered due to external pressure from the surrounding fluid.

The other options do not specifically relate to pericardial tamponade. Increased abdominal girth may indicate abdominal conditions such as ascites but is not a hallmark sign of tamponade. High fever with chills often suggests infection or inflammation rather than direct cardiac issues like tamponade. Marked cyanosis of the extremities may indicate poor peripheral perfusion or respiratory failure but does not directly diagnose pericardial tamponade. Therefore, the presence of muffled heart sounds is a critical and specific finding that signals the