mmHg and a diastolic value of 80, the normal pulse pressure is 40.
It is the difference between systolic and diastolic pressure. Thus, in a patient with a systolic value of 120
mmHg and a diastolic value of 80, the normal pulse pressure is 40.
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Not a wicked pressure, but instead the sum of systolic plus twice the diastolic pressure, divided by three. This is in recognition of the different durations of systole and diastole (with the latter being usually twice as long as systole), thus contributing unequally to average blood pressure values. Hence, in a patient with a blood pressure of 120/80 mmHg, the mean arterial pressure would be (120 + [2 × 80]) ÷ 3 = 280 ÷ 3 = 93.33.
In acute settings, it always carries a bad prognosis. Data confirm this ominous significance in cases of
acute myocardial infarction, pneumonia, and intensive care unit hospitalization in general. A condition seen in shock, where the high peripheral vascular resistance tightens arteries to the point of
impairing the generation of Korotkoff sounds. This prevents effective measurement of systolic and diastolic pressures, and may lead to gross underestimation. Both pseudohypertension and pseudohypotension can be counteracted by a direct intra-arterial recording. A form of hypertension associated with one or more of the following end-organ damages: rapid deterioration
of renal function, retinal hemorrhages or optic nerve involvement, left ventricular failure, myocardial ischemia, or cerebrovascular accidents. This may occur independently of the level of hypertension. Hence, patients with very high pressure may not develop malignant hypertension, whereas those with pressures as low as 180/120 mmHg may present with it. Probably not as much as traditionally taught. It has moderate to modest intraobserver and interobserver
agreement, and occurs frequently in the elderly, hypertensive or not. Also, many Osler’s cases do not really have pseudohypertension, since both indirect and intra-arterial recordings actually show lower blood pressure. Palpability of an artery in the absence of its pulse is a sign of arteriosclerosis. It suggests that both systolic
and diastolic pressures might be overestimated (pseudohypertension). A bedside test for the detection of pseudohypertension. It is carried out by first inflating the cuff until it
obliterates the radial pulse, and then by feeling the radial artery. If the cuff is unavailable, the radial pulse can be obliterated by compressing the brachial artery with the other thumb. The maneuver is positive when the artery remains palpable as a firm “tube” (positive Osler’s sign). A stiffening of the arterial wall. This leaves the vessel patent (and thus able to produce Korotkoff sounds),
even when the cuff pressure has exceeded the systolic blood pressure. An elevated indirect recording of blood pressure in patients with normal intra-arterial measurements. It is
uncommon, seen in fewer than 2% of otherwise healthy elderly people. |