A 29 year old man was involved in an RTA (road traffic accident). He presents with distended neck veins, clear breath sounds and a trachea which is in the midline. His RR (respiratory rate) 34bpm, BP=60/0mmHg. What is the most likely diagnosis?

The key is C. Cardiac tamponade. [Cardiac tamponade is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. The condition is a medical emergency, the complications of which include pulmonary edema, shock, and death. Distended neck vein, clear breath sound, tracheal shift and BP of 60/0 points towards cardiac tamponade].