Pulsus paradoxus is most commonly associated with which condition?

Pulsus paradoxus is most commonly associated with which condition?

• A. Pulsus alternans
• B. Pulsus bisferiens
• C. Pulsus paradoxus
• D. Pulsus parvus

Answer: (C)

Pulsus paradoxus is an exaggerated drop in systolic blood pressure with inspiration, typically defined as a fall greater than about 10 mm Hg. This sign is most classically linked to cardiac tamponade, where the heart is constrained by a fluid-filled pericardial sac. During inspiration, increased venous return to the right ventricle worsens interventricular dependence and reduces left ventricular stroke volume, producing a larger-than-normal drop in systolic pressure. While it can also appear with severe asthma or COPD due to marked intrathoracic pressure changes, tamponade is the best-known association and the one most often tested. Other pulse phenomena describe different processes—pulsus alternans reflects beat-to-beat variation from severe left ventricular dysfunction, pulsus bisferiens shows two systolic peaks seen with certain aortic conditions, and pulsus parvus is a small, delayed pulse seen with low stroke volume. The key idea is the abnormal inspiratory BP fall that points toward tamponade.

Pulsus paradoxus is an exaggerated drop in systolic blood pressure with inspiration, typically defined as a fall greater than about 10 mm Hg. This sign is most classically linked to cardiac tamponade, where the heart is constrained by a fluid-filled pericardial sac. During inspiration, increased venous return to the right ventricle worsens interventricular dependence and reduces left ventricular stroke volume, producing a larger-than-normal drop in systolic pressure. While it can also appear with severe asthma or COPD due to marked intrathoracic pressure changes, tamponade is the best-known association and the one most often tested. Other pulse phenomena describe different processes—pulsus alternans reflects beat-to-beat variation from severe left ventricular dysfunction, pulsus bisferiens shows two systolic peaks seen with certain aortic conditions, and pulsus parvus is a small, delayed pulse seen with low stroke volume. The key idea is the abnormal inspiratory BP fall that points toward tamponade.