Pulsus paradoxus
From IDWiki
Definition
- An exaggerated decrease in blood pressure on inspiration by > 10 mmHg
Pathophysiology
- Essentially, competition between the right and left chambers of the heart for limited space
Differential Diagnosis
- Pericardial
- Cardiac tamponade
- Constrictive pericarditis
- Cardiac non-pericardial
- RV infarction
- Restrictive cardiomyopathy
- Non-cardiac
- Asthma: LR+ 8.2 when >20 mmHg for severe bronchospasm
- Chronic obstructive pulmonary disease
- Obstructive sleep apnea
- Tension pneumothorax
- Pulmonary embolism
- Bilateral pleural effusion
- Marked obesity
- Hypovolemic shock
- Pectus excavatum
- Extrinsic cardiac compression
