Pulsus paradoxus is seen in all except :
Correct Answer: IPPV
Description: Answer is A (IPPV) Pulsus paradoxus is not a feature of IPPV. Pulsus paradoxus may be seen in association with cardiac tamponade, constrictive pericarditis (infrequent) and COPD. Causes of Pulsus Paradoxus 1. Clinical Disease States Cardiac Tamponade (common) Constrictive Pericarditis (Infrequent) Superior vena cava syndrome Obstructive Airway disease (Emphysema) Acute Asthma Pulmonary embolism Hypovolemic shock 2. In the absence of clincal disease Obesity Pregnancy What is Pulsus Paradoxus Normally the aerial pulse volume and aerial blood pressure decreases during inspiration and increases during expiration. Pulsus paradoxus is an aggravation of a normal process and hence also called pulses normalis aggregans. In pulses paradoxus the decrease in systolic aerial pressure during inspiration is accentuated. What then in the paradox: In patients with pericardial tamponade, airway obstruction or superior vena caval obstruction, the decrease in systolic aerial pressure may be so much that the peripheral pulse may completely disappear during inspiration. The paradox is that the hea sounds may still be heard on auscultation over the apex at a time when no pulse is palpable at the radial aery.
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