Age of puberty, age of drinking, and age of driving. In other words, the normal respiratory swing in systolic
pressure is usually in the range of a magic number frequently encountered in clinical medicine: age of
puberty (but also anion gap, osmolar gap, alveolar– arterial oxygen gradient, Hill's sign, and pulsus
paradoxus)—all 12 ± 2. To stretch this analogy a bit further, we might even say that a pulsus paradoxus can
be normal all the way up to 16 (i.e., the age of driving). For values between 16 and 21 (age of drinking), a
“pulsus paradoxus” has been reported (albeit not consistently) in:
Pulmonary embolism
Right ventricular infarction
Right ventricular failure
Severe congestive heart failure
Values in this range also occur in tamponade, and 30–45% of patients with constrictive pericarditis, but
this must have an exudative component and not be completely “dry.” Conversely, values above 21 are due
to only two conditions: tamponade and status asthmaticus
pressure is usually in the range of a magic number frequently encountered in clinical medicine: age of
puberty (but also anion gap, osmolar gap, alveolar– arterial oxygen gradient, Hill's sign, and pulsus
paradoxus)—all 12 ± 2. To stretch this analogy a bit further, we might even say that a pulsus paradoxus can
be normal all the way up to 16 (i.e., the age of driving). For values between 16 and 21 (age of drinking), a
“pulsus paradoxus” has been reported (albeit not consistently) in:
Pulmonary embolism
Right ventricular infarction
Right ventricular failure
Severe congestive heart failure
Values in this range also occur in tamponade, and 30–45% of patients with constrictive pericarditis, but
this must have an exudative component and not be completely “dry.” Conversely, values above 21 are due
to only two conditions: tamponade and status asthmaticus