Paradoxical pulse: what is it and when does it occur?

The heart rate, or pulse, is an individual indicator characterizing the number of heart beats per minute. The magnitude is not constant and depends on the activity of a person. So, while running, the heart rate is much higher than during sleep. Pulse in an adult is primarily a control of his health.

Normal heart rate

The rate of heart rate is different for all ages:

• The newborn is 120-160.
• From 1 month to 1 year - 80-140.
• From 2 to 6 years - 75-120.
• From 7 to 12 years - 75-110.
• Pulse in an adult (from 18 years) - 60-100.
• For athletes - 40-60 beats per minute.

What factors influence the heart rate?

The amount of heart rate is affected by such factors:

• Ambient temperature.
• Position of the body.
• Training.
• Emotional state (with agitation, stress, fear, anger, there is an increase in heart rate).
• Obesity.
• Taking medications.
• Smoking.
• Reception of alcohol.

If an adult untrained patient has a heart rate of less than 60 bpm, then bradycardia is indicated. Tachycardia is the opposite of bradycardia, a disease in which the heart beats more than 100 beats per minute.

How to measure the pulse on the arm?

Pulse can easily be measured on the wrist, namely the radial artery. To do this, you need to place your hand up in the palm of your hand, fixing two fingers of the other hand on your wrist. The tremors of blood felt by the pads of the fingers - this is the heart contractions, or the pulse. Using a clock or a stopwatch and counting the number of jerks within a minute, you can set the heart rate.

How to measure the pulse on the hand, should be known to everyone, because this simple knowledge can be useful at any time.

The paradoxical pulse - what is it?

This term in medicine is called excessive decrease during a quiet inhalation of systolic blood pressure. Paradoxical pulse, as a rule, is a consequence of other diseases.

At what diseases does

The appearance in the patient of a similar phenomenon of pulse disturbance is a consequence of such diseases:

• Cardiac tamponade is a violation of the filling of the ventricles, resulting from the accumulation of fluid in the pericardial cavity. As a result, intrapericardial pressure rises, and the patient has a paradoxical pulse (occurs in 100% of patients with cardiac tamponade).
• Constrictive pericarditis is a complication of acute pericarditis, resulting from mediastinal irradiation. The disease leads to the fact that the ventricle of the heart is not filled, which, in turn, is the impetus to the inevitable increase in venous pressure. The sufferer of the disease observes a rapid fatigue, a decrease in working capacity, as well as a manifestation of signs of stagnation of the veins. The paradoxical pulse with pericarditis is a mass phenomenon, occurs in 30-45% of patients.
• Diseases of the lungs (emphysema, bronchial asthma, hyperventilation). Such diseases of the respiratory system lead to the deposition of blood during inspiration, resulting in a decrease in systolic pressure. Thus, 80% of those suffering from bronchial asthma have a paradoxical pulse.
• Obesity - a violation of the pulse in this case occurs as a result of large, excessive fluctuations in intrathoracic pressure.

Other causes of the paradoxical pulse

In addition to the above, there are other reasons for this phenomenon:

• State of shock.
• Heart attack of the right ventricle.
• Lack of right ventricle.
• Severe heart failure.

What is a reverse paradoxical pulse?

The reverse paradoxical pulse is just the opposite phenomenon, consisting in an increase in systolic pressure. Symptoms are mainly on inspiration.

The reasons for the inverse paradoxical pulse are:

• Hypertrophic obstructive cardiomyopathy is a dangerous disease, often a cause of sudden cardiac arrest in adolescents and young adults. Identify the disease can only be an electrocardiographic study. Symptoms are shortness of breath, fluid retention, tachycardia. As a rule, the disease has a family character and is inherited.
• Lack of the left ventricle is characterized by hemodynamic disorders in patients at rest (in the initial stages). That is why the disease is often detected much later, when everything grows into a serious condition. In the critical stage of the process, the needs of the body are not fully ensured, which leads to serious consequences: to stagnation of blood in the lungs and left atrium.
• Disturbance of ventilation of lungs (occurrence of a positive pressure on an exhalation).

How to determine the paradoxical pulse

The presence of a phenomenon in an adult person can be said if the pulse pressure indicators during each inspiration decrease by more than 10 mm Hg. The mechanism of the onset of the paradoxical pulse is complex and has not been fully understood. It should immediately consult a doctor with symptoms such as severe shortness of breath, bronchial asthma, as well as with frequent, pronounced differences in intrathoracic pressure.

How to measure a paradoxical pulse

Measurement of the paradoxical pulse is possible with the help of a sphygmomanometer, while self-fixation is unacceptable. The doctor should sit at the patient's bed in such a way as to simultaneously observe the breathing of his ward and the mercury column on the device. It is necessary to pump pneumatic cuff as much as possible until all extraneous auscultatory sounds disappear, then start to blow it off slowly. When lowering the cuff, be sure to follow the movements of the chest and abdominal walls of the patient, recording the amount of pressure as soon as Korotkov's tones are heard. The second value of blood pressure is fixed, as soon as Korotkov's tones become visible not only on exhalation, but also on inspiration. The difference between the values found is the desired paradoxical pulse, measured in millimeters of mercury.

It is worth remembering that our health is in our hands. A timely call to a doctor can prevent the development of many serious diseases. Even minor symptoms, sometimes seeming trivial, can signal the progression of the disease. Take care of yourself, your family and friends. Do not ignore your own well-being and do not be afraid to seek qualified help!