{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:46:28Z","timestamp":1775123188187,"version":"3.50.1"},"reference-count":109,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,9,10]],"date-time":"2018-09-10T00:00:00Z","timestamp":1536537600000},"content-version":"vor","delay-in-days":40,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Reviewed the etiologies, pathophysiologic mechanisms, detection and clinical significance of pulsus paradoxus in various conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data source<\/jats:title><jats:p>We searched PubMed, EMBASE, and the CINAHL from inception to June 2017. We used the following search terms: Pulsus paradoxus, pericardial effusion, acute asthma, ventricular interdependence and so forth. All types of study were chosen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and conclusion<\/jats:title><jats:p>Legendary physician Sir William Osler truly said that \u201cMedicine is learned by the bedside and not in the classroom.\u201d Bedside history taking and physical examination should be an integral component of clinical teaching curriculum imparted to medical students. Pulsus paradoxus is a valuable physical sign seen in many clinical conditions. Pulsus paradoxus is defined by an inspiratory fall in systolic blood pressure of greater than 10 mm Hg. Two prototype examples of pulsus paradoxus are cardiac tamponade and acute asthma. Exaggerated swings of intrapleural pressure, bi\u2010ventricular interactions and increase afterload of the left ventricle are few of the pathophysiological mechanisms involved in the causation of pulsus paradoxus. The sensitivity of pulsus paradoxus in the diagnosis of cardiac tamponade is very high. In acute asthma, it also correlates with the severity of airflow obstruction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/crj.12912","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T05:30:15Z","timestamp":1528263015000},"page":"2321-2331","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pulsus paradoxus"],"prefix":"10.1111","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2644-2750","authenticated-orcid":false,"given":"Malay","family":"Sarkar","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine IGMC  Shimla Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeev","family":"Bhardwaj","sequence":"additional","affiliation":[{"name":"Department of Cardiology IGMC  Shimla Himachal Pradesh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-2413","authenticated-orcid":false,"given":"Irappa","family":"Madabhavi","sequence":"additional","affiliation":[{"name":"Department of Medical and Pediatric Oncology  Gujarat Ahmedabad India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivas","family":"Gowda","sequence":"additional","affiliation":[{"name":"PGIMER  Chandigarh India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kushal","family":"Dogra","sequence":"additional","affiliation":[{"name":"IGMC  Shimla India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,10]]},"reference":[{"key":"e_1_2_29_2_1","unstructured":"WooHE FungCH.\u201cRemarkable Physicians associated with Pulsus Paradoxus the Classic Sign \u2013 Richard Lower and Adolf Kussmaul\u201d History of Medicine On\u2010Line [serial online].2006.http:\/\/www.priory.com\/homol\/pulsus.htm. Accessed August 4 2016."},{"key":"e_1_2_29_3_1","first-page":"38","article-title":"Pericarditis and the paradox pulse","author":"Kussmaul A","year":"1873","journal-title":"Berl Klin Wochenschr."},{"key":"e_1_2_29_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(88)90487-5"},{"key":"e_1_2_29_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00138912"},{"key":"e_1_2_29_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.64.3.633"},{"key":"e_1_2_29_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08763-9"},{"key":"e_1_2_29_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-99-5-608"},{"key":"e_1_2_29_9_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.81.1.47"},{"key":"e_1_2_29_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(73)80132-8"},{"issue":"3","key":"e_1_2_29_11_1","first-page":"263","article-title":"Pulsus Paradoxus in a Neonate with Interrupted Aortic Arch","volume":"53","author":"Saini SS","year":"2016","journal-title":"Indian Pediatr."},{"key":"e_1_2_29_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra022643"},{"issue":"1","key":"e_1_2_29_13_1","first-page":"46","article-title":"Clinical signs in medicine: pulsus paradoxus","volume":"48","author":"Khasnis A","year":"2002","journal-title":"J Postgrad Med."},{"key":"e_1_2_29_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.62.727.377"},{"key":"e_1_2_29_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.2.609"},{"key":"e_1_2_29_16_1","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2009.850"},{"key":"e_1_2_29_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(67)90084-1"},{"key":"e_1_2_29_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1924.00110270071008"},{"key":"e_1_2_29_19_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.100.4.894"},{"issue":"3","key":"e_1_2_29_20_1","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1152\/ajplegacy.1955.180.3.463","article-title":"Effect of mean circulatory filling pressure and other peripheral circulatory factors on cardiac output","volume":"180","author":"Guyton A","year":"1955","journal-title":"Am J Physiol."},{"key":"e_1_2_29_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e3181672607"},{"key":"e_1_2_29_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.3.2.210"},{"key":"e_1_2_29_23_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1955.35.1.123"},{"key":"e_1_2_29_24_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1960.15.4.557"},{"key":"e_1_2_29_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.54.6.666"},{"key":"e_1_2_29_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197908303010901"},{"key":"e_1_2_29_27_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.27.020176.002341"},{"key":"e_1_2_29_28_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197709152971107"},{"key":"e_1_2_29_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(81)90022-0"},{"issue":"1","key":"e_1_2_29_30_1","first-page":"39","article-title":"De l'asystolie veineuse dans l'hypertrophie du coeur gauche par stenose concomitante du ventricule droit","volume":"4","author":"Elezi A","year":"2014","journal-title":"Rev Med."},{"key":"e_1_2_29_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.46.4.564"},{"key":"e_1_2_29_32_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.18.2.209"},{"key":"e_1_2_29_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4682-6-15"},{"key":"e_1_2_29_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.42.3.433"},{"key":"e_1_2_29_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1924.00110270092009"},{"key":"e_1_2_29_36_1","doi-asserted-by":"publisher","DOI":"10.1113\/eph8802418"},{"key":"e_1_2_29_37_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2272020366"},{"key":"e_1_2_29_38_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12111001"},{"key":"e_1_2_29_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0033-0620(67)80006-9"},{"key":"e_1_2_29_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.16.1810"},{"key":"e_1_2_29_41_1","first-page":"105","volume-title":"Tractatus De Corde, Item De Motu Et Colore Sanguinis Et Chyli in Eum Transitu","author":"Lower R.","year":"1669"},{"key":"e_1_2_29_42_1","first-page":"661","volume-title":"Diseases of the Heart and Circulation","author":"Wood P.","year":"1956"},{"key":"e_1_2_29_43_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI104711"},{"key":"e_1_2_29_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(52)90502-3"},{"key":"e_1_2_29_45_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI105295"},{"key":"e_1_2_29_46_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.48.5.701"},{"key":"e_1_2_29_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet011"},{"issue":"6","key":"e_1_2_29_48_1","first-page":"443","article-title":"Cardiac tamponade with the absence of a paradoxical pulse. The practical utility of echocardiography","volume":"48","author":"Zamorano J","year":"1995","journal-title":"Rev Esp Cardiol."},{"key":"e_1_2_29_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(79)90330-8"},{"key":"e_1_2_29_50_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.58.2.265"},{"key":"e_1_2_29_51_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.82.4.1370"},{"key":"e_1_2_29_52_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.33.5.763"},{"key":"e_1_2_29_53_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-91-3-403"},{"key":"e_1_2_29_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(87)90663-2"},{"key":"e_1_2_29_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2003.09.015"},{"key":"e_1_2_29_56_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197301112880203"},{"key":"e_1_2_29_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)93324-2"},{"key":"e_1_2_29_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(71)90307-X"},{"key":"e_1_2_29_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(78)90553-6"},{"key":"e_1_2_29_60_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02790383"},{"key":"e_1_2_29_61_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-2113.154517"},{"key":"e_1_2_29_62_1","unstructured":"Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma.http:\/\/www.nhlbi.nih.gov\/guidelines\/asthma\/01_front.pdf. Accessed May 25 2018."},{"issue":"1","key":"e_1_2_29_63_1","first-page":"1","article-title":"British Thoracic Society; Scottish Intercollegiate Guidelines Network","volume":"69","author":"British guideline on the management of asthma","year":"2014","journal-title":"Thorax."},{"key":"e_1_2_29_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2466-10-17"},{"key":"e_1_2_29_65_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1979.47.3.582"},{"key":"e_1_2_29_66_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1979.47.2.257"},{"key":"e_1_2_29_67_1","first-page":"647","volume-title":"Handbook of Physiology","author":"Permutt S","year":"1986"},{"key":"e_1_2_29_68_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.2.7842183"},{"key":"e_1_2_29_69_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.66.4.887"},{"key":"e_1_2_29_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/0033-0620(79)90017-3"},{"key":"e_1_2_29_71_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.92.5.789"},{"key":"e_1_2_29_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(86)80179-6"},{"key":"e_1_2_29_73_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.97.2.377"},{"key":"e_1_2_29_74_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.95.4.888"},{"issue":"2","key":"e_1_2_29_75_1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1152\/jappl.1982.52.2.333","article-title":"Mechanical cardiopulmonary interdependence","volume":"52","author":"Lloyd TC.","year":"1982","journal-title":"J Appl Physiol: Respirat Environ Exercise Physiol."},{"key":"e_1_2_29_76_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1980.121.3.441"},{"key":"e_1_2_29_77_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10010226"},{"key":"e_1_2_29_78_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.62.6.1297"},{"key":"e_1_2_29_79_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.56.6.951"},{"key":"e_1_2_29_80_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1990.68.5.1927"},{"key":"e_1_2_29_81_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0808836"},{"key":"e_1_2_29_82_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-2810"},{"key":"e_1_2_29_83_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.115.2.475"},{"key":"e_1_2_29_84_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0030208"},{"key":"e_1_2_29_85_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.100.13.1380"},{"key":"e_1_2_29_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(61)90422-2"},{"key":"e_1_2_29_87_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035630"},{"key":"e_1_2_29_88_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197908303010905"},{"key":"e_1_2_29_89_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90706-X"},{"key":"e_1_2_29_90_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(65)90339-5"},{"key":"e_1_2_29_91_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.34.11.1137"},{"key":"e_1_2_29_92_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/151.3_Pt_1.904"},{"key":"e_1_2_29_93_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(91)90494-3"},{"key":"e_1_2_29_94_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-8932(08)75749-X"},{"key":"e_1_2_29_95_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.157.1.9701071"},{"key":"e_1_2_29_96_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.02.019"},{"key":"e_1_2_29_97_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI105665"},{"key":"e_1_2_29_98_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1138459"},{"issue":"2","key":"e_1_2_29_99_1","first-page":"142","article-title":"Measurement of pulsus paradoxus","volume":"16","author":"Sulzbach LM.","year":"1989","journal-title":"Focus Crit Care."},{"issue":"4","key":"e_1_2_29_100_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1542\/peds.83.4.507","article-title":"Acute asthma: observations regarding the management of a pediatric emergency room","volume":"83","author":"Canny GJ","year":"1989","journal-title":"Pediatrics."},{"key":"e_1_2_29_101_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.158.1.48"},{"key":"e_1_2_29_102_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960260504"},{"key":"e_1_2_29_103_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050557"},{"issue":"2","key":"e_1_2_29_104_1","first-page":"68","article-title":"Pulsus paradoxus","volume":"3","author":"Fowler NO.","year":"1994","journal-title":"Heart Dis Stroke."},{"key":"e_1_2_29_105_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197312132892403"},{"key":"e_1_2_29_106_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)83207-4"},{"key":"e_1_2_29_107_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.68.2.266"},{"key":"e_1_2_29_108_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1978.44.5.703"},{"key":"e_1_2_29_109_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196609000-00009"},{"key":"e_1_2_29_110_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.64.5.671"}],"container-title":["The Clinical Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcrj.12912","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/crj.12912","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T04:18:16Z","timestamp":1695010696000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/crj.12912"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":109,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1111\/crj.12912"],"URL":"https:\/\/doi.org\/10.1111\/crj.12912","archive":["Portico"],"relation":{},"ISSN":["1752-6981","1752-699X"],"issn-type":[{"value":"1752-6981","type":"print"},{"value":"1752-699X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8]]},"assertion":[{"value":"2017-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}