Exam

Pulsus Paradoxus

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Pulsus Paradoxus, Paradoxical Pulse

  • Definition
  1. Inspiratory decrease in arterial pressure >10 mm Hg
  2. Inspiratory venous pressure unchanged (Kussmaul's Sign)
  • Causes
  1. Pericardial Effusion
  2. Adhesive Pericarditis
  3. Cardiac Tamponade
  4. Pulmonary Emphysema
  5. Severe Asthma
  6. Para-mediastinal effusion
  7. Endocardial fibrosis
  8. Myocardial Amyloidosis
  9. Scleroderma
  10. Mitral Stenosis with right Heart Failure
  11. Tricuspid stenosis
  12. Hypovolemia
  13. Pulmonary Embolism
  • Signs
  1. Palpable decrease in pulse with inspiration
  2. Inspiratory systolic Blood Pressure decreased
    1. Over 10 mm Hg less than expiratory pressure