Pulsus paradoxus

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Background

  • An exaggerated drop in systemic blood pressure during inspiration
  • Caused by moderate-severe cardiac tamponade (and occasionally constrictive pericarditis)

Measurement

  • Severe pulsus paradoxus can be palpated in the pulse as a weakening or disappearance of the pulse during inspiration
  • Normally identified using BP
    • Use manually-operated sphygmomanometer
    • Deflate cuff more slowly than usual
  • Abnormal = >10mmHg
  • Sensitivty for tamponade = 80%
    • +LR = 3.3
    • -LR = 0.03

See Also

Cardiac Tamponade

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