{"id":21106,"date":"2015-12-19T08:34:37","date_gmt":"2015-12-19T03:04:37","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21106"},"modified":"2022-12-11T16:51:58","modified_gmt":"2022-12-11T11:21:58","slug":"reverse-pulsus-paradoxus","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/reverse-pulsus-paradoxus\/","title":{"rendered":"Reverse pulsus paradoxus"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/6UfQCkfnTEM\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Reverse pulsus paradoxus<\/span><\/h2>\n<p>Reverse pulsus paradoxus is an expiratory fall in pulse volume, the opposite of pulsus paradoxus. The classical causes of reverse pulsus paradoxus described are [1]:<\/p>\n<ol>\n<li><a href=\"\/professional\/isorhythmic-av-dissociation\/\">Isorhythmic atrioventricular dissociation<\/a><\/li>\n<li>Hypertrophic obstructive cardiomyopathy<\/li>\n<li>Intermittent positive pressure ventilation in the presence of left ventricular failure<\/li>\n<\/ol>\n<p>During intermittent positive pressure ventilation the swings in intrathoracic pressure is opposite to that of normal breathing. Hence the inspiratory blood pressure is higher than the expiratory blood pressure [2].<\/p>\n<p>In case of isorhythmic AV dissociation, inspiratory increase in sinus rate results in sinus rhythm dominating over AV dissociation. In sinus rhythm there is AV synchrony and hence a higher pulse volume, compared to AV dyssynchrony in expiration.<\/p>\n<p>In hypertrophic obstructive cardiomyopathy, the intensity of murmur decreases in inspiration due to decrease in obstruction. This is associated with an increase in arterial pressure and hence the reverse pulsus paradoxus [3].<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Massumi RA, Mason DT, Vera Z, Zelis R, Otero J, Amsterdam EA. Reversed pulsus paradoxus.&nbsp;N Engl J Med. 1973 Dec 13;289(24):1272-5.<\/li>\n<li>Wong FW. Pulsus paradoxus in ventilated and non-ventilated patients.&nbsp;Dynamics. 2007 Fall;18(3):16-8.<\/li>\n<li>Brilakis ES, Nishimura RA.&nbsp;Dynamic respiratory changes in hypertrophic cardiomyopathy.&nbsp;Heart. 2004 Mar;90(3):296.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Reverse pulsus paradoxus Reverse pulsus paradoxus is an expiratory fall in pulse volume, the opposite of pulsus paradoxus. The classical causes of reverse pulsus paradoxus described are [1]: Isorhythmic atrioventricular dissociation Hypertrophic obstructive cardiomyopathy Intermittent positive pressure ventilation in the presence of left ventricular failure During intermittent positive pressure ventilation the swings in intrathoracic pressure [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":40052,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-21106","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Reverse pulsus paradoxus is an expiratory fall in pulse volume<\/title>\n<meta name=\"description\" content=\"Reverse pulsus paradoxus - expiratory fall in pulse volume, opposite of pulsus paradoxus. Causes: Isorhythmic AV dissociation, HOCM, IPPV.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/reverse-pulsus-paradoxus\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Reverse pulsus paradoxus is an expiratory fall in pulse volume\" \/>\n<meta property=\"og:description\" content=\"Reverse pulsus paradoxus - expiratory fall in pulse volume, opposite of pulsus paradoxus. Causes: Isorhythmic AV dissociation, HOCM, IPPV.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/reverse-pulsus-paradoxus\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2015-12-19T03:04:37+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-12-11T11:21:58+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Reverse pulsus paradoxus\",\"datePublished\":\"2015-12-19T03:04:37+00:00\",\"dateModified\":\"2022-12-11T11:21:58+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/\"},\"wordCount\":195,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/\",\"name\":\"Reverse pulsus paradoxus is an expiratory fall in pulse volume\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/reverse-pulsus-paradoxus\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2015-12-19T03:04:37+00:00\",\"dateModified\":\"2022-12-11T11:21:58+00:00\",\"description\":\"Reverse pulsus paradoxus - expiratory fall in pulse volume, opposite of pulsus paradoxus. 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