Pulsus paradoxus; historical and clinical perspectives

Abstract

Pulsus paradoxus or the paradoxical pulse is an exaggeration of the normal inspiratory decrease in systolic blood pressure. The current definition of pulsus paradoxus is an inspiratory drop in systolic blood pressure>10 mm Hg. This physical sign can occur in conditions like cardiac tamponade, constrictive pericarditis, asthma and several other clinical conditions. The reduction in pulse volume during inspiration was first described by Richard Lower in 1669. Later, in 1850, Floyer described this sign in bronchial asthma. In 1873, Adolf Kussmaul coined the term "pulsus paradoxus" in three patients with constrictive pericarditis. In this article, we discuss both the historical and clinical perspectives of pulsus paradoxus.