CLINICAL MEDICINE

Detailed explanation-1: -Pulsus paradoxus is present as the decrease in systolic arterial pressure is >10 mmHg. Note that the arterial pulse pressure also decreases at inspiration, suggesting that left ventricular stroke volume decreases at inspiration.

Detailed explanation-2: -Severe pulsus paradoxus may be able to be appreciated as a weakening or disappearance of the palpated pulse during inspiration. Under certain circumstances, pulsus paradoxus may be able to be seen with respirophasic variations in the patient’s pulse oximetry waveform as well.

Detailed explanation-3: -Moderate to severe cardiac tamponade, and occasionally constrictive pericarditis, induce hemodynamic changes that enhance the inspiratory fall in systolic blood pressure. This exaggerated drop in systemic blood pressure during inspiration is termed pulsus paradoxus (waveform 1 and waveform 2).