Pulsus paradoxus.
OBJECTIVES
Reviewed the etiologies, pathophysiologic mechanisms, detection and clinical significance of pulsus paradoxus in various conditions.


DATA SOURCE
We searched PubMed, EMBASE, and the CINAHL from inception to June 2017. We used the following search terms: Pulsus paradoxus, pericardial effusion, acute asthma, ventricular interdependence and so forth. All types of study were chosen.


RESULTS AND CONCLUSION
Legendary physician Sir William Osler truly said that "Medicine is learned by the bedside and not in the classroom." Bedside history taking and physical examination should be an integral component of clinical teaching curriculum imparted to medical students. Pulsus paradoxus is a valuable physical sign seen in many clinical conditions. Pulsus paradoxus is defined by an inspiratory fall in systolic blood pressure of greater than 10 mm Hg. Two prototype examples of pulsus paradoxus are cardiac tamponade and acute asthma. Exaggerated swings of intrapleural pressure, bi-ventricular interactions and increase afterload of the left ventricle are few of the pathophysiological mechanisms involved in the causation of pulsus paradoxus. The sensitivity of pulsus paradoxus in the diagnosis of cardiac tamponade is very high. In acute asthma, it also correlates with the severity of airflow obstruction.
['Sarkar|Malay|M|http://orcid.org/0000-0002-2644-2750', 'Bhardwaj|Rajeev|R|', 'Madabhavi|Irappa|I|http://orcid.org/0000-0002-8543-2413', 'Gowda|Srinivas|S|', 'Dogra|Kushal|K|']
D001249:Asthma D001794:Blood Pressure D002305:Cardiac Tamponade D006352:Heart Ventricles D006801:Humans D000072277:Maximal Respiratory Pressures D029424:Pulmonary Disease, Chronic Obstructive D012120:Respiration Disorders D012720:Severity of Illness Index
pulsus paradoxus acute asthma ventricular interdependence pericardial tamponade