Exam

Pulse Pressure

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Pulse Pressure, Narrow Pulse Pressure

  • Definitions
  1. Pulse Pressure
    1. Difference between systolic pressure and diastolic pressure
    2. Represents the force of cardiac contraction
  • Exam
  • Normal Pulse Pressure
  1. Range: 30-40 mmHg
  • Causes
  • Wide (high) Pulse Pressure (>40 mmHg)
  1. Pathophysiology in Isolated Systolic Hypertension
    1. Suggests reduced large artery vascular compliance
    2. Best Blood Pressure marker for cardiovascular risk
  2. Causes
    1. Isolated Systolic Hypertension
    2. Aortic Regurgitation
    3. Thyrotoxicosis
    4. Patent Ductus Arteriosus
    5. Arteriovenous Fistula
    6. Beriberi heart
    7. Aortic Coarctation
    8. Anemia
    9. Emotional state
  • Causes
  • Narrow Pulse Pressure (<30 mmHg)
  1. Pathophysiology in Hypovolemic Shock
    1. Sympathetic response to decreased circulating Blood Volume
    2. Diastolic Blood Pressure increase without systolic Blood Pressure increase
  2. Causes
    1. Hypovolemic Shock or Hemorrhagic Shock
      1. May predict circulatory collapse in Trauma with Hemorrhage
      2. Prehospital Narrow Pulse Pressure predicts severe Trauma and need for aggressive Resuscitation
      3. Interpret in combination with Trauma Evaluation and other markers (Hypotension, Shock Index)
      4. Schellenberg (2021) J Surg Res 268:284-90 [PubMed]
    2. Tachycardia
    3. Severe Aortic Stenosis
    4. Constrictive Pericarditis
    5. Pericardial Effusion
    6. Ascites