How do you check for pulsus paradoxus?


How do you check for pulsus paradoxus?

To measure pulsus paradoxus all you need is a stethoscope and a blood pressure cuff. To test for pulsus paradoxus slowly look for the first quarter cough sound. That will appear then disappear during inspiration. Next slowly listen for when the first quarter cough sound no longer disappears with inspiration.

What is an abnormal pulsus paradoxus?

Pulsus paradoxus is defined as an abnormal inspiratory decrease in systolic blood pressure (>10 mm Hg) that usually results from the underlying mechanism of tamponade.

Why is there pulsus paradoxus in cardiac tamponade?

Moderate to severe cardiac tamponade, and occasionally constrictive pericarditis, induce hemodynamic changes that enhance the inspiratory fall in systolic blood pressure. This exaggerated drop in systemic blood pressure during inspiration is termed pulsus paradoxus (waveform 1 and waveform 2).

What happens to blood pressure during inspiration?

During inspiration, systolic blood pressure decreases, and pulse rate goes up. This is because the intrathoracic pressure becomes more negative relative to atmospheric pressure. This increases systemic venous return, so more blood flows into the right side of the heart.

What causes pulsus paradoxus in cardiac tamponade?

(See “Cardiac tamponade” and “Constrictive pericarditis”.) Pulsus paradoxus can be thought of as a direct result of competition (ie, enhanced chamber interaction) between the right and left sides of the heart for limited space; for the right heart to fill more, the left heart must fill less.

Why does inspiration decrease intrathoracic pressure?

Respiration – During inspiration, venous return increases as the thoracic cavity’s pressure becomes more negative. This reduced intrathoracic pressure draws more blood into the right atrium. This results in greater venous return.

How does inspiration increase heart rate?

This normal, physiologically adaptive mechanism serves to optimize gas exchange between the lungs and the circulatory system. Thus, during inspiration, when air is flowing into the lungs, the heart speeds up, increasing the opportunity for gas exchange via the higher rate of blood flowing through the lungs.