The respiratory therapist is monitoring the blood pressure of a patient in the emergency department and notes that the blood pressure is 15 mm Hg less on inspiration than on expiration

Question

Which of the following would most likely result in this finding?
a. The patient is hypovolemic.
b. The patient has a pulmonary embolism.
c. The patient is having a myocardial infarction.
d. The patient is having a severe exacerbation of asthma.

Answer 1

D
A change in blood pressure that is more than 10 mm Hg lower on inspiration than on expiration is known as pulsus paradoxus. This exaggerated waxing and waning of arterial blood pressure can be detected with a sphygmomanometer or, in severe cases, by palpating the pulse at the wrist or neck. Commonly associated with severe asthmatic episodes, pulsus paradoxus is believed to be caused by the major intrapleural pressure swings that occur during inspiration and expiration.