pulsus paradoxus
Pronunciation: PUL-sus pair-uh-DOK-sus
An abnormal decrease in systolic blood pressure of more than 10 mmHg during inspiration, indicating impaired venous return or cardiac filling.
Full Definition
Pulsus paradoxus is a physical examination finding where the systolic blood pressure drops by more than 10 mmHg during inspiration. Normally, inspiratory pressure drop is minimal (less than 10 mmHg), but in pathological conditions affecting cardiac filling or venous return, this drop becomes exaggerated. It is commonly associated with cardiac tamponade, severe asthma, or restrictive pericarditis. The finding is detected during blood pressure measurement when Korotkoff sounds disappear during inspiration at higher pressures than during expiration. A pulsus paradoxus greater than 20 mmHg is considered significant and may indicate cardiac tamponade.
Usage
Usage note: Often measured using a sphygmomanometer during routine blood pressure assessment.
In Context
- "The patient exhibited a pulsus paradoxus of 25 mmHg, concerning for cardiac tamponade." — physical examination note
- "Pulsus paradoxus was absent, making cardiac tamponade less likely." — clinical assessment