Pulsus paradoxus can indicate which post-cardiac surgery issue?

Pulsus paradoxus is a clinical phenomenon where there is a significant drop in blood pressure during inspiration, which exceeds 10 mm Hg. This condition is particularly indicative of cardiac tamponade, especially in the post-cardiac surgery context.

After surgery, fluid can accumulate in the pericardial space, leading to increased pressure on the heart, which hampers its ability to fill properly during diastole. This results in reduced stroke volume and, consequently, a drop in blood pressure during inspiration due to impaired venous return to the heart. The hallmark of cardiac tamponade is the presence of pulsus paradoxus.

In contrast, inadequate cardiac output, sepsis, and atrial flutter may present with various hemodynamic abnormalities, but they do not specifically cause the characteristic drop in blood pressure during inspiration that is seen in pulsus paradoxus. Thus, recognizing pulsus paradoxus as a sign of cardiac tamponade is crucial for timely diagnosis and intervention in the postoperative setting.