Chronic beta-blocker therapy complicating the presentation of cardiac tamponade of malignancy

A case report is related of an elderly patient with metastatic carcinoma who presented to the emergency department with mental status change and ultimately proved to have cardiac tamponade. All of the classic cardiovascular signs of this condition were obscured by chronic beta-blocker therapy and concurrent hypovolemia. A discussion of pertinent pathophysiology and review of the literature is included.