Pulsus paradoxus signals which condition most strongly?

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Multiple Choice

Pulsus paradoxus signals which condition most strongly?

Pulsus paradoxus is an exaggerated drop in systolic blood pressure during inspiration, usually more than 10 mm Hg. This occurs when the heart’s filling is limited and there is strong ventricular interdependence, most classically in cardiac tamponade. In tamponade, the pericardial pressure is high, so during inspiration venous return to the right heart increases and the septum shifts toward the left ventricle, reducing LV filling and stroke volume. That inspiratory decrease in LV output produces a larger drop in systolic BP with inspiration, hence pulsus paradoxus. This finding is most strongly associated with cardiac tamponade. Aortic stenosis produces a different pulse pattern (pulsus parvus et tardus) due to a fixed outflow obstruction. Pulmonary embolism and myocardial infarction can cause hypotension but do not characteristically cause pulsus paradoxus.

Pulsus paradoxus is an exaggerated drop in systolic blood pressure during inspiration, usually more than 10 mm Hg. This occurs when the heart’s filling is limited and there is strong ventricular interdependence, most classically in cardiac tamponade. In tamponade, the pericardial pressure is high, so during inspiration venous return to the right heart increases and the septum shifts toward the left ventricle, reducing LV filling and stroke volume. That inspiratory decrease in LV output produces a larger drop in systolic BP with inspiration, hence pulsus paradoxus.

This finding is most strongly associated with cardiac tamponade. Aortic stenosis produces a different pulse pattern (pulsus parvus et tardus) due to a fixed outflow obstruction. Pulmonary embolism and myocardial infarction can cause hypotension but do not characteristically cause pulsus paradoxus.

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