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Pulsus paradoxus

MedGen UID:
534282
•Concept ID:
C0232118
•
Finding
Synonyms: Finding of paradoxical pulse volume; Kussmaul pulse; Paradoxical pulse; Paradoxical pulse volume
SNOMED CT: Finding of paradoxical pulse volume (52099006); Paradoxical pulse volume (52099006); Pulsus paradoxus (52099006); Kussmaul pulse (52099006); Paradoxical pulse (52099006)
 
HPO: HP:6000046

Definition

Pulsus paradoxus refers to a systolic pressure drop greater than 10mmHg during inspiration. [from HPO]

Professional guidelines

PubMed

Diagnosis and management of cardiac tamponade in the era of echocardiography.
Tsang TS, Oh JK, Seward JB
Clin Cardiol 1999 Jul;22(7):446-52. doi: 10.1002/clc.4960220703. PMID: 10410287Free PMC Article
Childhood asthma--office management.
Shah MD
Indian J Pediatr 1996 Jan-Feb;63(1):37-44. doi: 10.1007/BF02823863. PMID: 10829963
Pericardial effusion and tamponade: evaluation, imaging modalities, and management.
Chong HH, Plotnick GD
Compr Ther 1995 Jul;21(7):378-85. PMID: 7554815

Recent clinical studies

Etiology

Interstitial pneumonia with autoimmune features.
Low QJ, Teo KZ, Thien LK, Lim TH, Cheo SW
J R Coll Physicians Edinb 2020 Dec;50(4):387-391. doi: 10.4997/JRCPE.2020.407. PMID: 33469613
Chapter 14: Acute severe asthma (status asthmaticus).
Shah R, Saltoun CA
Allergy Asthma Proc 2012 May-Jun;33 Suppl 1:47-50. doi: 10.2500/aap.2012.33.3547. PMID: 22794687
Sensitivity and specificity of echocardiographic evidence of tamponade: implications for ventricular interdependence and pulsus paradoxus.
Guntheroth WG
Pediatr Cardiol 2007 Sep-Oct;28(5):358-62. doi: 10.1007/s00246-005-0807-9. PMID: 17710357
Pulsus paradoxus in cardiac tamponade: a pathophysiologic continuum.
Swami A, Spodick DH
Clin Cardiol 2003 May;26(5):215-7. doi: 10.1002/clc.4960260504. PMID: 12769248Free PMC Article
Diagnosis and management of cardiac tamponade in the era of echocardiography.
Tsang TS, Oh JK, Seward JB
Clin Cardiol 1999 Jul;22(7):446-52. doi: 10.1002/clc.4960220703. PMID: 10410287Free PMC Article

Diagnosis

Pericardial tamponade: A comprehensive emergency medicine and echocardiography review.
Alerhand S, Adrian RJ, Long B, Avila J
Am J Emerg Med 2022 Aug;58:159-174. Epub 2022 May 6 doi: 10.1016/j.ajem.2022.05.001. PMID: 35696801
What echocardiographic findings suggest a pericardial effusion is causing tamponade?
Alerhand S, Carter JM
Am J Emerg Med 2019 Feb;37(2):321-326. Epub 2018 Nov 17 doi: 10.1016/j.ajem.2018.11.004. PMID: 30471929
Pulsus paradoxus.
Sarkar M, Bhardwaj R, Madabhavi I, Gowda S, Dogra K
Clin Respir J 2018 Aug;12(8):2321-2331. doi: 10.1111/crj.12912. PMID: 29873194
Tamponade: Hemodynamic and Echocardiographic Diagnosis.
Kearns MJ, Walley KR
Chest 2018 May;153(5):1266-1275. Epub 2017 Nov 11 doi: 10.1016/j.chest.2017.11.003. PMID: 29137910
Pulsus paradoxus.
Hamzaoui O, Monnet X, Teboul JL
Eur Respir J 2013 Dec;42(6):1696-705. Epub 2012 Dec 6 doi: 10.1183/09031936.00138912. PMID: 23222878

Therapy

Pulse oximetry respiratory monitoring for assessment of acute childhood wheeze.
Wertheim D, Anton O, Olden C, Le Maistre SLV, Seddon PC
Arch Dis Child 2022 Dec;107(12):1083-1087. Epub 2022 Aug 8 doi: 10.1136/archdischild-2021-323390. PMID: 35940849
Pericarditis.
Rahman A, Saraswat A
Aust Fam Physician 2017 Nov;46(11):810-814. PMID: 29101915
Chapter 14: Acute severe asthma (status asthmaticus).
Shah R, Saltoun CA
Allergy Asthma Proc 2012 May-Jun;33 Suppl 1:47-50. doi: 10.2500/aap.2012.33.3547. PMID: 22794687
Childhood asthma--office management.
Shah MD
Indian J Pediatr 1996 Jan-Feb;63(1):37-44. doi: 10.1007/BF02823863. PMID: 10829963
Respirator paradox.
Rick JJ, Burke SS
South Med J 1978 Nov;71(11):1376-8, 1382. doi: 10.1097/00007611-197811000-00018. PMID: 362537

Prognosis

Pericardial tamponade: A comprehensive emergency medicine and echocardiography review.
Alerhand S, Adrian RJ, Long B, Avila J
Am J Emerg Med 2022 Aug;58:159-174. Epub 2022 May 6 doi: 10.1016/j.ajem.2022.05.001. PMID: 35696801
The value of dynamic preload variables during spontaneous ventilation.
Perel A
Curr Opin Crit Care 2017 Aug;23(4):310-317. doi: 10.1097/MCC.0000000000000430. PMID: 28614095
Chapter 14: Acute severe asthma (status asthmaticus).
Shah R, Saltoun CA
Allergy Asthma Proc 2012 May-Jun;33 Suppl 1:47-50. doi: 10.2500/aap.2012.33.3547. PMID: 22794687
Diagnostic value of echocardiography in cardiac tamponade.
Tsang TS, Oh JK, Seward JB, Tajik AJ
Herz 2000 Dec;25(8):734-40. doi: 10.1007/pl00001991. PMID: 11200121
Childhood asthma--office management.
Shah MD
Indian J Pediatr 1996 Jan-Feb;63(1):37-44. doi: 10.1007/BF02823863. PMID: 10829963

Clinical prediction guides

Tamponade: Hemodynamic and Echocardiographic Diagnosis.
Kearns MJ, Walley KR
Chest 2018 May;153(5):1266-1275. Epub 2017 Nov 11 doi: 10.1016/j.chest.2017.11.003. PMID: 29137910
The value of dynamic preload variables during spontaneous ventilation.
Perel A
Curr Opin Crit Care 2017 Aug;23(4):310-317. doi: 10.1097/MCC.0000000000000430. PMID: 28614095
Pulsus paradoxus.
Hamzaoui O, Monnet X, Teboul JL
Eur Respir J 2013 Dec;42(6):1696-705. Epub 2012 Dec 6 doi: 10.1183/09031936.00138912. PMID: 23222878
Pulsus paradoxus in ventilated and non-ventilated patients.
Wong FW
Dynamics 2007 Fall;18(3):16-8. PMID: 17879762
Childhood asthma--office management.
Shah MD
Indian J Pediatr 1996 Jan-Feb;63(1):37-44. doi: 10.1007/BF02823863. PMID: 10829963

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