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In AF - there is mismatch between the apical rate (heart rate) and radial rates. esp in rapid rates. apical rate is more accurate. not all the beats are transmitted to the radial pulse at such high rates.
The Following User Says Thank You to J.T. For This Useful Post:
Pulsus paradoxus seem to have generated bit of a discussion here. Everyone is correct in their own right. As the site is mainly catered for medical students who, of course, need to pass the exam before tagging prefix "doctor", they need to know all the causes of the sign. I believe this is a very favourite MCQ question including MRCP Part I.
When you move to day to day clinical practice, patients don't come reading books and present to us with exactly what is well documented. How many of us have seen above stated condition presenting with pulsus paradoxus in daily clinical practice? Most of these cases are picked up and get adequately managed before they reach to develop pulsus paradoxus, especially in this day and age. As one honourable member has stated that not all the above mentioned conditions present with pulsus paradoxus which, in most caes, is seen only in late stages, if not preterminal.
Anil Tuladhar MRCP(UK), FRCPCH
University Hospital of North Tees
Cleveland
UK
Last edited by Anil Tuladhar; 05-06-2006 at 11:10 AM.
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