Family Nurse Practitioner Exam

Pulsus paradoxus is characterized by which of the following changes in blood pressure?

1. An increase in systolic blood pressure on inspiration

2. A decrease in diastolic blood pressure on exhalation

3. A decrease in systolic blood pressure on inspiration

4. An increase in diastolic blood pressure on expiration

The correct answer is: A decrease in systolic blood pressure on inspiration

Pulsus paradoxus is a significant clinical finding indicative of conditions such as cardiac tamponade, severe asthma, or other forms of obstructive lung disease. It is characterized by a notable decrease in systolic blood pressure during inspiration. This phenomenon occurs due to increased intrathoracic pressure during inspiration, which compresses the heart and limits diastolic filling, ultimately leading to reduced stroke volume and thus lower systolic blood pressure. The decrease in systolic blood pressure is typically measured as a drop of more than 10 mm Hg during inspiration compared to the pressure during expiration. In contrast, the other options describe changes that do not align with the clinical definition and mechanics of pulsus paradoxus. Understanding this physiological response is critical for accurately diagnosing and managing conditions associated with cardiovascular instability.