aetiology

Last reviewed 01/2018

The causes of pulsus paradoxus include:

  • obstructive airways disease:
    • during inspiration, the lower intrathoracic pressure favours the venous filling of the right ventricle more than the left
    • the relative overfilling of the right ventricle may compromise the lumen of the left ventricle resulting in a lower stroke volume and lower systolic pressure

  • pericardial tamponade:
    • increased intra-pericardial pressure during inspiration results in a compensatory increase in central venous pressure (Kussmaul's sign)
    • on the left side of the heart there is insufficient pressure to maintain the filling of the left ventricle: a low stroke volume results in a low systolic pressure