Paramedics respond to A patient with a stab wound to the left anterior chest. The patient is conscious but anxious with pale, cool clammy skin. Vital signs revealed blood pressure 82/68 heart rate 126 bpm respiratory rate 28 per minute and shallow SPO2 89% on room air. Your physical assessment reveals JVD distant heart sounds and narrowed pulse pressure which pathophysiological process is occurring. That explains these assessment findings.