A reversal of the normal variation in the pulse volume with respiration, the pulse becoming weaker with inspiration and stronger with expiration; characteristic of cardiac tamponade and rare in constrictive pericarditis. So called because these changes are independent of changes in the cardiac rate as measured directly or by electrocardiogram. Pulsus paradoxus (also paradoxical pulse, pulsus respiratio, Kussmaul pulse) is a historic term acknowledging the paradox of a fluctuating pulse volume despite regular heart sounds, with the fluctuations associated with the respiratory cycle. Gauchat's succinct and elegant 1924 definition of pulsus paradoxus is notable. The rhythmical throbbing of arteries produced by the regular contractions of the heart, especially as palpated at the wrist or in the neck.

• Pulse Paradoxus Define
• Paradoxical Pulse Pressure
• Paradoxical Pulse In Tamponade
• How To Check Paradoxical Pulse
• Paradoxical Pulse Examination

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pulse

[puls] 2. the beat of the heart as felt through the walls of a peripheral artery, such as that felt in the radial artery at the wrist. Other sites for pulse measurement include the side of the neck (carotid artery), the antecubital fossa (brachial artery), the temple (temporal artery), the anterior side of the hip bone (femoral artery), the back of the knee (popliteal artery), and the instep (dorsalis pedis artery).
What is felt is not the blood pulsing through the arteries (as is commonly supposed) but a shock wave that travels along the walls of the arteries as the heart contracts. This shock wave is generated by the pounding of the blood as it is ejected from the heart under pressure. It is analogous to the hammering sound heard in steam pipes as the steam is forced into the pipes under pressure. A pulse in the veins is too weak to be felt, although sometimes it is measured by sphygmograph (see below); the tracing obtained is called a phlebogram.
The pulse is usually felt just inside the wrist below the thumb by placing two or three fingers lightly upon the radial artery. The examiner's thumb is never used to take a pulse because its own pulse is likely to be confused with that of the patient. Pressure should be light; if the artery is pressed too hard, the pulse will disappear entirely. The number of beats felt in exactly 1 minute is the pulse rate.
In taking a pulse, the rate, rhythm, and strength or amplitude of the pulse are noted. The average rate in an adult is between 60 and 100 beats per minute. The rhythm is checked for possible irregularities, which may be an indication of the general condition of the heart and the circulatory system.
The amplitude of a pulse can range from totally impalpable to bounding and full; however, such terms are vague and subject to misinterpretation. To provide a more standardized description of pulse amplitude some agencies and hospitals use a scale that provides a more objective evaluation and reporting of the force of a pulse. On such a scale zero would mean that the pulse cannot be felt; +1 would indicate a thready, weak pulse that is difficult to palpate, fades in and out, and is easily obliterated with slight pressure; +2 would be a pulse that requires light palpation but once located would be stronger than a +1; +3 would be considered normal; and a +4 pulse would be one that is strong, bounding, easily palpated, and perhaps hyperactive, and could indicate a pathological condition such as aortic regurgitation.
If a pulse is noted to be weaker during inhalation and stronger during exhalation (pulsus paradoxus), this could indicate either greater reduction in the flow of blood to the left ventricle than is normal, as in constrictive pericarditis or pericardial effusion, or a grossly exaggerated inspiratory maneuver, as in tracheal obstruction, asthma, or emphysema.
An instrument for registering the movements, form, and force of the arterial pulse is called a sphygmograph. The sphygmographic tracing (or pulse tracing) consists of a curve having a sudden rise (primary elevation) followed by a sudden fall, after which there is a gradual descent marked by a number of secondary elevations.

paradoxical pulse

Synonym: Kussmaul's pulse; pulsus paradoxus
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Pulse Paradoxus Define

par·a·dox

(păr′ə-dŏks′)n.

Adj.

1.

paradoxical - seemingly contradictory but nonetheless possibly true; 'it is paradoxical that standing is more tiring than walking' incomprehensible, inexplicable - incapable of being explained or accounted for; 'inexplicable errors'; 'left the house at three in the morning for inexplicable reasons'

paradoxical

paradoxical

paradox

(ˈpӕrədoks) nounˌparaˈdoxical adjectiveˌparaˈdoxically adverb

Paradoxical Pulse Pressure

Paradoxical Pulse In Tamponade

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How To Check Paradoxical Pulse

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Paradoxical Pulse Examination