During multiple unsuccessful transseptal approach there is hypotension , congested neck veins what is the cause.. Injury to the aorta and cardiac tamponade

During multiple unsuccessful transseptal approach there is hypotension , congested neck veins what is the cause:
- vasovagal attack
- Injury of the bundle of his.
- Myocardial infarction.
- Injury to the aorta and cardiac tamponade.***