An absolute contraindication to performing pericardiocentesis for cardiac tamponade is:

• A. Active infection
• B. Coagulopathy
• C. No absolute contraindications in this setting
• D. Seizures

Answer: (C)

Relieving tamponade quickly is life-saving, because the accumulating fluid compresses the heart and severely limits cardiac output. Pericardiocentesis directly relieves that pressure, so in this emergency the benefit far outweighs the risks. There are no absolute barriers to performing the procedure in this setting; conditions like active infection at the access site or coagulopathy are managed around the procedure rather than stopping it. Even though an infection or a bleeding tendency increases risk, pericardiocentesis is still performed with sterile technique and, if possible, with coagulation correction or careful technique (often under ultrasound guidance). Seizures do not preclude the procedure either, as necessary precautions and airway management can be taken. Thus, there are no absolute contraindications to pericardiocentesis for cardiac tamponade in this emergent context.