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Case No. 168

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Shortness of...

Shortness of breath and Muffled Heart Sounds

Clinical 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
  • 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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