The patient's cardiac exam reveals a ______ pulse, where the pulse amplitude decreases during inspiration, indicating pericardial tamponade.
1paradoxical✓ 정답
2alternating
3bounding
4thready
5water-hammer
해설
A paradoxical pulse, where systolic blood pressure falls abnormally (>10 mmHg) during inspiration, is a key finding in cardiac tamponade. This occurs due to increased negative intrathoracic pressure during inspiration, which further impairs left ventricular filling in the setting of tamponade.
• Pathophysiology of cardiac tamponade:
- Fluid accumulation in pericardial space
- Restricted cardiac filling
- Decreased stroke volume
- Compromised cardiac output
• Common causes:
- Pericarditis
- Trauma
- Malignancy
- Post-cardiac surgery
- Uremia
- Infection
• Treatment options:
- Pericardiocentesis
- Surgical pericardiectomy
- Volume expansion
- Treatment of underlying cause
핵심 개념
paradoxical — A condition where something behaves in a way that contradicts normal physiological patterns, specifically referring to an abnormal decrease in systolic blood pressure during inspiration
alternating — A pulse pattern that regularly varies in strength between beats, often associated with certain cardiac conditions
bounding — A strong, forceful pulse that can be easily felt and is often associated with high cardiac output states
thready — A weak, thin pulse that is difficult to palpate, often indicating poor peripheral perfusion
water-hammer — A forceful, rapidly collapsing pulse characteristic of aortic regurgitation, also known as Corrigan's pulse