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The symptom most indicative of pericardial tamponade is when the diastolic blood pressure is higher than the systolic blood pressure, a condition known as pulsus paradoxus. In pericardial tamponade, increased pressure in the pericardial sac prevents the heart from filling properly during diastole, which can result in a widening pulse pressure. This is often characterized by a drop in systolic blood pressure and an increase in diastolic pressure, leading to the unique situation where the diastolic reading appears to be higher than the systolic reading during measurements.

This circumstance reflects the impaired hemodynamic status due to the obstruction of the heart's ability to expand fully, revealing the critical nature of the condition. Other symptoms such as decreased heart rate, increased stroke volume, or muffled breath sounds do not specifically indicate pericardial tamponade. Instead, they can be associated with a variety of other conditions or physiological responses, making the shift in blood pressure readings the most telling sign in this scenario.