Pulsus Paradoxus: Causes & Reasons

Possible Causes for Pulsus Paradoxus

paradoxus > 10 mmHg plus evidence of a large pericardial effusion with echocardiographic signs of tamponade in the absence of other cardiac disease, as defined in the IMPI [clinicaltrials.gov]

paradoxus. [amboss.com]

3.3; 95% CI, 1.8-6.3), while a pulsus paradoxus of 10 mm Hg or less greatly lowers the likelihood (likelihood ratio, 0.03; 95% CI, 0.01-0.24). [jamanetwork.com]

Cardiac Tamponade

Pulsus paradoxus Pulsus paradoxus (or paradoxical pulse) is an exaggeration (>12 mm Hg or 9%) of the normal inspiratory decrease in systemic blood pressure. [emedicine.medscape.com]

This review explains the manifestations of tamponade, including a presentation in which the diagnostic finding of pulsus paradoxus is absent, and variant forms, such as low-pressure [doi.org]

3.3; 95% CI, 1.8-6.3), while a pulsus paradoxus of 10 mm Hg or less greatly lowers the likelihood (likelihood ratio, 0.03; 95% CI, 0.01-0.24). [scholar.harvard.edu]

Hemopericardium

However, collapses need not be present even in florid tamponade and particularly in some cases with chamber hypertrophy.2 Similarly, the absence of pulsus paradoxus correlates [ahajournals.org]

At admission, the heart rate was 112 bpm, and the patient had elevated jugular venous pressure, pulsus paradoxus, and distant heart sounds on auscultation. [academic.oup.com]

Detection of pulsus paradoxus associated with large pericardial effusions in pediatric patients by analysis of the pulse-oximetry waveform. Pediatrics. 2002;109:673–77. [ncbi.nlm.nih.gov]

Chronic Constrictive Pericarditis

This situation, termed “pulsus paradoxus,” is the classic hallmark of cardiac tamponade. [aafp.org]

paradoxus in the absence of an effusion annulus paraxodus elevated filling pressures with a preserved mitral septal annular velocity ( septal e' ) annulus reversus tissue [radiopaedia.org]

Pulsus paradoxus, a finding in cardiac tamponade, is uncommon [ 2 ]. [patient.info]

Pericardial Neoplasm

Pulsus paradoxus: In this condition, inspiratory drop in systolic blood pressure is more than 10mmHg. Pulsus paradoxus and cardiac tamponade. [drnajeeblectures.com]

Cardiac tamponade is diagnosed on the basis of clinical (engorged jugular veins, pulsus paradoxus) and echocardiographic (right atrial wall collapse, dilated vena cava) findings [moh-it.pure.elsevier.com]

Pulsus paradoxus: exaggeration of the normal respiratory variation in systemic blood pressure (defined as a decrease in systolic blood pressure of more than 10 mm Hg with [patient.info]

Restrictive Cardiomyopathy

Pulsus paradoxus does not occur. [merckmanuals.com]

The absence of pulsus paradoxus helps to differentiate RCM from constrictive pericarditis. Patients may complain about chest pain due to compression of small vessels. [symptoma.com]

Bronchial Asthma

Severe airflow obstruction may be predicted by accessory muscle use, pulsus paradoxus, refusal to recline below 30°, a pulse >120 beats/min, and decreased breath sounds. [doi.org]

Extrathoracic respiratory signs should also be systematically looked for, including cyanosis, finger deformation, pulsus paradoxus, and pursed lips breathing. [erj.ersjournals.com]

>42 mmHg SaO 2 Pulsus paradoxus can be a valuable sign of asthma severity but its detection should not delay prompt treatment. [ncbi.nlm.nih.gov]

Hypovolemia

“pulsus paradoxus” on the arterial pressure curve. ...read moreread less A. Convertino, Donovan L. Fogt, William H. Cooke, Steven A. Romero, Gilbert Moralez, Caroline A. [typeset.io]

Alpha-1 Antitrypsin Deficiency

Airflow obstruction manifests as pursed-lip breathing, wheezing, and pulsus paradoxus. [emedicine.medscape.com]

Other findings on physical examination include pulsus paradoxus, scalene muscle retraction, intercostal muscle retraction, wheezing, hepatomegaly, hyperinflation results in [wikidoc.org]

Cardiac tamponade presents with dyspnea, tachycardia, elevated jugular venous pressure, and pulsus paradoxus.[15] The gold standard for diagnosis is ultrasound.[15] Anaphylaxis [en.wikipedia.org]

Chronic Obstructive Pulmonary Disease

Cardiac tamponade presents with dyspnea, tachycardia, elevated jugular venous pressure, and pulsus paradoxus.[15] The gold standard for diagnosis is ultrasound.[15] Anaphylaxis [en.wikipedia.org]

Congestive Heart Failure

Cardiac tamponade presents with dyspnea, tachycardia, elevated jugular venous pressure, and pulsus paradoxus.[15] The gold standard for diagnosis is ultrasound.[15] Anaphylaxis [en.wikipedia.org]

Status Asthmaticus

paradoxus >25 mm Hg, peak expiratory flow rate Altered mental status, paradoxical respirations, bradycardia, a quiet chest, and absence of pulsus paradoxus from respiratory [accessmedicine.mhmedical.com]

Altered mental status, paradoxical respirations, bradycardia, a quiet chest, and absence of pulsus paradoxus from respiratory muscle fatigue identify imminent respiratory [accessmedicine.mhmedical.com]

Severe airflow obstruction may be predicted by accessory muscle use, pulsus paradoxus, refusal to recline below 30°, a pulse >120 beats/min, and decreased breath sounds. [doi.org]

Mediastinopericarditis

(Kussmaul, 1873/2006) Pulsus Paradoxus: Modern Definition : The modern definition of pulsus paradoxus is the greater than 10 mm Hg inspiratory decline in systolic arterial [priory.com]

What is reverse pulsus paradoxus? [clinicalmedicineupdate.blogspot.com]

Keywords: Constrictive pericarditis, Kussmaul's sign, pulsus paradoxus How to cite this article: Singh N, Chadha DS, Bharadwaj P, Agarwal N. [j-pcs.org]

Constrictive Pericarditis

Examination revealed elevated neck veins, pulsus paradoxus, muffled heart sounds, decreased breath sounds and pedal oedema. [ncbi.nlm.nih.gov]

In some cases the pericardium retains some elasticity as it thickens and pulsus paradoxus may be present. [thoracickey.com]

Hemodynamic pulsus paradoxus was measured from a recording of femoral-artery pressure obtained during spontaneous respiration. [nejm.org]

Pericarditis

paradoxus. [ncbi.nlm.nih.gov]

To measure pulsus paradoxus, the sphygmomanometer cuff is inflated above systolic pressure. [racgp.org.au]

This situation, termed “pulsus paradoxus,” is the classic hallmark of cardiac tamponade. [aafp.org]

Acute Pleuropericarditis

To measure pulsus paradoxus, the sphygmomanometer cuff is inflated above systolic pressure. [racgp.org.au]

paradoxus : ↓ blood pressure amplitude during deep inspiration References: [5] [6] [7] [8] [9] [2] Diagnostics The diagnosis is based primarily on a history of pleuritic [amboss.com]

Pulsus paradoxus was 20mmHg and there was jugular venous distension to the angle of the mandible Heart rate was tachycardic with an irregular rhythm and distant heart sounds [hopkinsarthritis.org]

Hypovolemic Shock

[…] close Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. Log out Cancel Updated: Oct 13, 2016 Author: Paul Kolecki, MD, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP more... Overview Background[…] [emedicine.medscape.com]

Pericardial Calcification

IPP of 25mmHg drops during inspiration to 10mmHg (producing a pulsus paradoxus). [brown.edu]

This situation, termed “pulsus paradoxus,” is the classic hallmark of cardiac tamponade. [aafp.org]

paradoxus, JVP increases, kaussmaul’s sign, Muffled S1&S2 Diagnosis: Beck’s triad: falling bp, rising JVP, small, quiet heart Big globular heart ( if > 250ml fluid) ECG – [wikilectures.eu]

Pericardial Disorder

paradoxus. [amboss.com]

Pulsus paradoxus reflects a decrease in systolic BP with inspiration of more than 12 mm Hg. Pulsus paradoxus also occurs in severe asthma or COPD exacerbations. [healio.com]

Other frequent symptoms are pulsus paradoxus, pericardial friction sounds, tachycardia, tachypnea, weakened peripheral pulses, edema, cyanosis. [ecgwaves.com]

Radiation Pericarditis

IPP of 25mmHg drops during inspiration to 10mmHg (producing a pulsus paradoxus). [brown.edu]

This situation, termed “pulsus paradoxus,” is the classic hallmark of cardiac tamponade. [aafp.org]

Pulsus paradoxus, a finding in cardiac tamponade, is uncommon [ 2 ]. [patient.info]

Suppurative Pericarditis

The ECG-changes were uncharacteristic, and a friction rub and pulsus paradoxus was encountered once only. [ncbi.nlm.nih.gov]

paradoxus: Pulsus paradoxus is measured by careful auscultation with a blood pressure cuff. [odlarmed.com]

Pulsus paradoxus: In this condition, inspiratory drop in systolic blood pressure is more than 10mmHg. Pulsus paradoxus and cardiac tamponade. [drnajeeblectures.com]

Acute Pericarditis

paradoxus : ↓ blood pressure amplitude during deep inspiration References: [5] [6] [7] [8] [9] [2] Diagnostics The diagnosis is based primarily on a history of pleuritic [amboss.com]

Pulsus paradoxus: definition and relation to the severity of cardiac tamponade. Am Heart J 1988; 115:391–398. Bilchick KC, Wise RA. [clevelandclinicmeded.com]

Your healthcare provider may also check for pulsus paradoxus. This is when your blood pressure drops when you take a deep breath. [cedars-sinai.edu]

Superior Vena Cava Syndrome

The approach to an intrinsic cause of superior vena cava syndrome (SVCS) is usually difficult but rewarding. We report a case of a middle-aged man who presented with progressive oedema of the upper half of the body, dyspnoea, cough and weight loss for a 1-year duration. He was a non-smoker without prior[…] [ncbi.nlm.nih.gov]

Post-Infarction Pericarditis

Pulsus paradoxus (>10 mm Hg drop in blood pressure during inspiration) is specific for tamponade. [forums.studentdoctor.net]

paradoxus Kussmaul's sign Pericardial knock Peripheral edema Ascites Diagnosis of constrictive pericarditis EKG-non-specific ST and T wave changes Chest xray-calcification [quizlet.com]

paradoxus). [textbookofcardiology.org]

Pneumopericardium

It can be congenital, or introduced by a wound.[3] Presentation[edit] The symptomatic patient may present with dyspnea, cyanosis, chest pain, pulsus paradoxus, bradycardia [en.wikipedia.org]

Dressler Syndrome

Physical examination revealed jugular venous distention and pulsus paradoxus but no pericardial friction rub. [nejm.org]

Familial Pericarditis

Pulsus paradoxus: exaggeration of the normal respiratory variation in systemic blood pressure (defined as a decrease in systolic blood pressure of more than 10 mm Hg with [patient.info]

paradoxus, and the Beck's triad of low blood pressure (due to decreased cardiac output ), distant (muffled) heart sounds, and distension of the jugular vein (JVD). [en.wikipedia.org]

Pulsus Paradoxus: see here for information on how to perform this evaluation 15% of idiopathic pericarditis Up to 60% of malignant, purulent, or tuberculous pericarditis Electrocardiography [utswim.wordpress.com]

Traumatic Heart Rupture

 Muffled heart sounds  Hypotension  Distended neck veins  Others  Pulsus paradoxus  Kussmaul’s sign 6. 20% 80% Cardiac injury temponade hemorrhage 7.  High index [slideshare.net]

Observations on pulsus paradoxus (with special reference to pericardial effusions): I. Clinical. [acls.com]

The main clinical signs, which may be subtle but should be sought, are: Signs similar to that of tamponade; in particular that of hypotension, pulsus paradoxus and raised [sjtrem.biomedcentral.com]

Chylopericardium

He had pulsus paradoxus with distant heart sounds. [ncbi.nlm.nih.gov]

Pericardiocentesis

He had a respiratory rate of 18/minute, heart rate of 77/minute and blood pressure of 130/72 without pulsus paradoxus. [cathlabdigest.com]

Pulsus paradoxus ii. [neoreviews.aappublications.org]

The decision to tap is easy in patients with classic findings of tamponade as noted above, with hypotension, tachycardia, and pulsus paradoxus. [cathlabdigest.com]