Pulsus paradoxus seen in all EXCEPT:
Correct Answer: Mitral regurgitation
Description: Ans. d (Mitral Regurgitation). (Ref. Harrison, Principles of Medicine, 18th/Chapter 227.)Pulsus paradoxus is measured by noting the difference between the systolic pressure at which the Korotkoff sounds are first heard (during expiration) and the systolic pressure at which the Korotkoff sounds are heard with each heartbeat, independent of the respiratory phase. Between these two pressures, the Korotkoff sounds are heard only intermittently and during expiration. The cuff pressure must be decreased slowly to appreciate the finding. It can be difficult to measure pulsus paradoxus in patients with tachycardia, atrial fibrillation, or tachypnea. A pulsus paradoxus may be palpable at the brachial artery or femoral artery level when the pressure difference exceeds 15 mmHg. This inspiratory fall in systolic pressure is an exaggerated consequence of interventricular dependence.ARTERIAL PULSESMECHANISMEncountered inPulsus paradoxusDecrease in SBP (< 10 mm Hg) that normally accompanies decrease in arterial pulse amplitude during inspiration is accentuated.It refers to a fall in systolic pressure >10 mmHg with inspiration.- Pericardial effusion- Pericardial tamponade0- Pulmonary embolism (massive)- SVC obstruction- Hemorrhagic shock- Severe obstructive lung disease- Tension pneumothorax.
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