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Old 09-27-2012
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Default Please help me understand this question!

A 37 y.o. patient is being assessed in the ER for shortness of breath and lightheadedness. The BP cuff is inflated to 130 mmHG and the pressure is slowly released. At 100 mmHG intermittent Korotkoff sounds are heard only during expiration. At 78 mmHG Korotkoff sounds are heard throughout the respiratory cycle. Which of the Following is the most likely explanation to the physical finding?

A. Aortic Dissection
B. Peripheral Vascular Disease
C. Aortic Valve disease
D. Mitral Valve disease
E. Pericardial disease.

The answer is E. Pericardial disease.
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Old 09-27-2012
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Default Pulsus paradoxus

They described pulsus paradosus.which is seen in pericarditis,asthma,cardiac tamponade,croup and obstructive sleep apnea
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Old 09-27-2012
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Default How?

how you get pulsus paradoxsus from that vignette?
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Old 09-27-2012
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Default

Pulsus paradoxus is exaggerated fall in BP during inspiration. So, when pt inspires BP is less than what in Expiration

e.g, at Inspiration BP=70 mmHg, at Expiration BP= 90mmHg.. if BP cuff is inflated to 80mmHg.. Korotkoff sounds will be heard only in Expiration.

Hope u understand.
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