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Kussmaul's pulse or sign

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A manifestation of limited expansion of the right ventricle. A reversal of the normal pattern of decreasing jugular venous pressure during inspiration.

Pulsus paradoxus, a different entity, is an exaggeration of the normal inspiratory decrease in systolic blood pressure. It is an important sign for cardiac tamponade but it can sometimes be seen in constrictive pericarditis or chronic obstructive airways disease.

We thank Luis Enrique Farias Curtidor and Jongoh Kim for submitting information.


  • A. Kussmaul:
    Über schwielige Mediastino-Perikarditis und den paradoxen Puls.
    Berliner klinische Wochenschrift, 1873, 10: 433-435, 445-449 and 461-464.
  • Kenneth C Bilchick, Robert A Wise:
    Paradoxical physical findings described by Kussmaul: pulsus paradoxus and Kussmaul's sign. The Lancet, 2002, 359: 1940-1942.

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