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The human heart has four chambers, with the left ventricle’s capacity inhibited during inhalation, causing a drop in blood pressure known as pulsus paradoxus. Paradoxical pulse can detect various heart conditions and is evaluated with Kussmaul’s sign. It can be caused by fluid pushing on the heart, a heart attack, or bronchial asthma. Doctors use a combination of methods to evaluate heart health and determine the causes of a paradoxical pulse.
The human heart consists of four chambers, including two atria in the upper part of the organ and two ventricles in the lower half. A muscle called the septum separates the chambers on the right side of the heart from those on the left. Located within a sac called the pericardium, the heart is affected by the movement of the body’s structures, including the lungs. The capacity of the left ventricle is somewhat inhibited during inhalation as the lungs expand and push on the right ventricle. During a heartbeat, blood pressure can drop when a person inhales; if this effect is more pronounced than normal, it is called pulsus paradoxus.
Systolic blood pressure is typically represented by the highest number on a reading. The paradoxical pulse phenomenon is so named because during a medical examination, heart sounds can be heard even between pulses. Paradoxical pulse can be used to detect and diagnose various heart conditions. It is often evaluated in conjunction with Kussmaul’s sign, which is the change in the shape and pressure of the veins that can be caused by pressure on the heart.
When paradoxical pulse is detected, a doctor can further examine a patient in a variety of ways. An examination of the carotid artery and peripheral artery pulses is often done. Blood pressure cuffs can also be used to measure the sound of the heart, and waveform analysis is often done on people with blocked airways or who are in intensive care. The paradoxical pulse can be caused by fluid pushing on the heart, a heart attack, blockage of blood vessels in the lungs, and shock to the heart. Other causes may be obesity, a herniated diaphragm or anaphylactic shock.
Bronchial asthma can also cause paradoxical pulse. Mechanically, the effect may be triggered by the inability of pressure to be adequately transmitted through the heart. Blood in the lungs can pool as a person inhales, and if the space around the heart is narrowed, this often occurs as well. Breathing disorders associated with asthma can increase pressure around the heart, affecting the way blood is pumped when the heart is constricted by abnormal lung activity.
Paradoxical pulse is expected in various diseases, but it does not always occur if there are defects in the septum or in the aorta, which is the main artery leaving the heart. Doctors generally have to look for a combination of things when evaluating heart health. The causes of a paradoxical pulse can be determined by evaluating heart sounds with a precordial examination, taking an X-ray, or giving an EKG.
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