Pulsus paradoxus is most closely associated with which condition?

Pulsus paradoxus is most closely associated with which condition?

• A. Asthma
• B. Pulmonary embolism
• C. Cardiac tamponade
• D. Myocardial infarction

Answer: (C)

Pulsus paradoxus is an exaggerated drop in systolic blood pressure during inspiration, usually more than 10 mm Hg. It happens because inspiration normally shifts more blood to the right heart, but when the heart is confined by fluid in the pericardium, this shift causes the septum to bulge into the left ventricle and markedly reduce left-sided stroke volume. The result is a larger-than-normal dip in systolic pressure with inspiration. This pattern is most classically seen with cardiac tamponade, where pericardial fluid restricts heart filling and accentuates the inspiratory fall in pressure. It can occur in other severely obstructive or hypoxic conditions, but tamponade is the strongest and most characteristic association.

Pulsus paradoxus is an exaggerated drop in systolic blood pressure during inspiration, usually more than 10 mm Hg. It happens because inspiration normally shifts more blood to the right heart, but when the heart is confined by fluid in the pericardium, this shift causes the septum to bulge into the left ventricle and markedly reduce left-sided stroke volume. The result is a larger-than-normal dip in systolic pressure with inspiration. This pattern is most classically seen with cardiac tamponade, where pericardial fluid restricts heart filling and accentuates the inspiratory fall in pressure. It can occur in other severely obstructive or hypoxic conditions, but tamponade is the strongest and most characteristic association.