What is pulsus paradoxus (PP), also known as paradoxic pulse and paradoxical pulse? It is an exaggeration of the normal variation in the pulse during the inspiratory phase of respiration, in which the pulse becomes weaker as one inhales and stronger as one exhales. The modern definition of pulsus paradoxus is the greater than 10 mm Hg inspiratory decline in systolic arterial pressure. It is a sign that is indicative of several conditions including cardiac tamponade, pericarditis, pericardial effusion, hypovolemia, and pulmonary embolism. Non cardiac causes include asthma and emphysema.[1]
The paradox in pulsus paradoxus is that, on clinical examination, one can also detect beats on cardiac auscultation during inspiration that cannot be palpated at the radial pulse.[1] It results from an accentuated decrease of the blood pressure, which leads to the (radial) pulse not being palpable and may be accompanied by an increase in the jugular venous pressure height (Kussmaul sign). As is usual with inspiration, the heart rate is slightly increased,[2] due to decreased left ventricular output.[3]
This is what you will see on
your monitor if pt has Artline
Q: What should you do if you suspect this?
A: Notify Dr.
Q: you also note an increased CVP/RAP and /or narrow pulse pressure, and increased heart rate… What might be your differential diagnosis be?
A: give me your answer, if you are correct I will give you points
Brandy, are we supposed to post our answer or email it to you?
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