Pulsus paradoxus

Pulsus paradoxus is an inspiratory fall in systolic BP greater than 10mmHg.

In a ‘normal’ person the systolic BP usually falls around 6mmHg in inspiration. The ‘paradox’ refers to the fact that although the radial pulse is absent, heart sounds can be auscultated.

The commonest cause of pulsus paradoxus is cardiac tamponade (sensitivity 98%, specificity 83%) 

Other causes of pulsus paradoxus include: 

Pulsus paradoxus can be measured by 
  • Cuff sphygmonanometry 
  • Arterial waveform analysis 
  • Pulse oximetry waveform analysis 

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Secret collector of interesting anonymised ECGs. Fan of the Bath Photomarathon. Lover of cream teas. [Sarah Hudson] (Your Picture)