Intended for healthcare professionals


Children with pulsus paradoxus . . . and other stories

BMJ 2020; 369 doi: (Published 11 June 2020) Cite this as: BMJ 2020;369:m2207

Pulsus paradoxus

Pulsus paradoxus is an exaggeration of the normal fall in stroke volume and systolic pressure that occurs during inspiration. It’s paradoxical only because it is possible to detect heart beats by chest auscultation that can’t be palpated at the wrist. Once a classic sign of cardiac tamponade, pulsus paradoxus isn’t often looked for these days. However, a study from a children’s hospital in Singapore reports that it can be detected by inspection of the output of a pulse oximeter and that it’s a useful sign in children with asthma (Arch Dis Child doi:10.1136/archdischild-2019-318043). Children in whom pulsus paradoxus persisted beyond initial treatment were likely to require admission to intensive care.

Noise as a risk factor for vestibular schwannoma

Vestibular schwannoma is a benign tumour arising from the nerve sheath of the vestibular branch of the 8th cranial nerve. Epidemiological investigations have suggested that loud noise is a risk …

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