Case No. 168

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Case No. 168

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Chief Complaint:

Shortness of breath and Muffled Heart Sounds

Published: Dec. 6, 2017
Case No. 168
Author: jason.lopez
CASE SCENARIO

A 72year old male presents to the Emergency Department for a cough. He reports several days of a dry cough and mild shortness of breath. Pulmonary exam is unremarkable. Cardiac exam is notable for muffled heart sounds. You obtain a chest-x-ray, which shows an enlarged cardiac silhouette. You suspect that the patient has a pericardial effusion and perform pulsus paradoxus to evaluate for cardiac tamponade.

QUESTION

Which statement is correct regarding pulsus paradoxus?

Defined as a decrease in systolic blood pressure >10mmHg during inspiration
Defined as a decrease in systolic blood pressure >10mmHg during expiration
Defined as a decrease in systolic blood pressure >15mmHg during inspiration
Defined as a decrease in systolic blood pressure >15mmHg during expiration
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