Pulsus paradoxus
Pulsus paradoxus (pronounced: puhl-sus puh-ruh-dok-sus) is a medical term that refers to an exaggerated decrease in pulse amplitude during inspiration.
Etymology
The term "Pulsus paradoxus" is derived from Latin, where "pulsus" means pulse and "paradoxus" means contrary to expectation. This term was first used in the late 19th century to describe the unusual finding of a pulse that becomes weaker with inspiration, which is contrary to the normal physiological response.
Definition
Pulsus paradoxus is defined as a decrease in systolic blood pressure of more than 10 mm Hg during inspiration. It is a clinical sign that is often associated with conditions that cause reduced cardiac output, such as cardiac tamponade, constrictive pericarditis, and severe asthma or chronic obstructive pulmonary disease (COPD).
Measurement
The measurement of pulsus paradoxus involves the use of a sphygmomanometer and a stethoscope. The blood pressure cuff is inflated above the systolic pressure, and then slowly deflated. The pressure at which sounds are first heard (during expiration) and the pressure at which sounds are heard throughout the respiratory cycle (during both expiration and inspiration) are recorded. The difference between these two pressures is the pulsus paradoxus.
Clinical Significance
Pulsus paradoxus is a significant clinical sign that can indicate severe conditions such as cardiac tamponade, constrictive pericarditis, severe asthma, or COPD. It is also seen in obstructive sleep apnea and in some patients with heart failure. The presence of pulsus paradoxus can help guide diagnostic testing and treatment decisions.
Related Terms
- Cardiac tamponade
- Constrictive pericarditis
- Asthma
- Chronic obstructive pulmonary disease
- Systolic blood pressure
- Cardiac output
- Sphygmomanometer
- Stethoscope
- Obstructive sleep apnea
- Heart failure
External links
- Medical encyclopedia article on Pulsus paradoxus
- Wikipedia's article - Pulsus paradoxus
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