Family Nurse Practitioner Exam

What is the condition most likely associated with pulsus paradoxus?

1. Sarcoidosis

2. Acute bronchitis

3. Status asthmaticus

4. Bacterial pneumonia

The correct answer is: Status asthmaticus

Pulsus paradoxus is characterized by a drop in blood pressure of more than 10 mmHg during inspiration, which can be indicative of underlying pathophysiological changes in the cardiovascular system. The condition most commonly associated with pulsus paradoxus is status asthmaticus, a severe exacerbation of asthma that leads to significant airway obstruction and impaired respiratory mechanics. In status asthmaticus, increased intrathoracic pressure during inspiration can exacerbate the already compromised venous return to the heart, leading to a decrease in stroke volume and consequently lower blood pressure during inspiration. This phenomenon occurs due to the dynamic changes in pressure within the thoracic cavity, which particularly affects patients experiencing severe bronchospasm and difficulty in airflow, typical of this acute asthmatic condition. In contrast, while other respiratory issues, such as sarcoidosis, acute bronchitis, and bacterial pneumonia may lead to respiratory distress, they are not primarily characterized by the same pronounced effects on cardiovascular dynamics as seen in status asthmaticus. Therefore, the association of pulsus paradoxus with status asthmaticus is well-established in medical practice, making it the correct choice in this context.