What does pulsus paradoxus indicate?

What does pulsus paradoxus indicate?

• A. Pericardial tamponade
• B. Hypovolemia
• C. Sepsis
• D. Pulmonary edema

Answer: (A)

Pulsus paradoxus is an exaggerated drop in systolic blood pressure during inspiration, reflecting limited ventricular filling due to intrathoracic changes. This finding most strongly signals pericardial tamponade, where a growing pericardial effusion raises intrapericardial pressure and restricts diastolic filling. As you inspire, the right ventricle fills more and, because the pericardial constraint prevents the left ventricle from expanding, the left-sided stroke volume falls—producing a larger-than-normal drop in systolic pressure, i.e., a paradoxical pulse. While other conditions can cause hypotension, they do not characteristically produce this inspiratory BP drop. Therefore, pulsus paradoxus most points to tamponade.

Pulsus paradoxus is an exaggerated drop in systolic blood pressure during inspiration, reflecting limited ventricular filling due to intrathoracic changes. This finding most strongly signals pericardial tamponade, where a growing pericardial effusion raises intrapericardial pressure and restricts diastolic filling. As you inspire, the right ventricle fills more and, because the pericardial constraint prevents the left ventricle from expanding, the left-sided stroke volume falls—producing a larger-than-normal drop in systolic pressure, i.e., a paradoxical pulse. While other conditions can cause hypotension, they do not characteristically produce this inspiratory BP drop. Therefore, pulsus paradoxus most points to tamponade.