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A post-operative cardiac surgical patient developed  sudden hypotension, raised central venous pressure,  pulsus paradoxus at the 4 post operative hour. The  most probable diagnosis is:  

A. Excessive mediastinal bleeding  

B. Ventricular dysfunction  

C. Congestive cardiac failure  

D. Cardiac tamponade
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D. Cardiac tamponade
D. Cardiac tamponade