Small pulse compression

Introduction Under normal circumstances, the normal person's pulse pressure difference is 30-40 mmHg, if the pulse pressure difference is less than 30mmHg, it can be determined that the pulse pressure difference is small. The pulse pressure difference is too low to be seen in patients with early hypertension. Blood pressure refers to the pressure on the side walls of blood vessels when blood flows. Blood pressure is divided into systolic and diastolic blood pressure, and the difference between systolic blood pressure and diastolic blood pressure is called "pulse pressure difference". For example, the systolic blood pressure is 120 mm Hg, the diastolic blood pressure is 80 mm Hg, and the pulse pressure difference is 40 mm Hg. Pulse pressure reduction is common: low blood pressure, pericardial effusion, severe mitral stenosis, severe heart failure and other diseases.

Cause

Due to the increased sympathetic excitability of the patient, the small blood vessels in the whole body are paralyzed, so that the systolic blood pressure is not high, the diastolic blood pressure is relatively increased, and the pulse pressure difference is small. Pulse pressure difference is small physiological and pathological, physiological factors are generally due to physical weakness and weakness, pathological factors such as myocardial infarction, cardiac insufficiency, pericardial stenosis, aortic stenosis, pericardial effusion, contraction Narrow pericarditis, severe mitral stenosis, severe heart failure, peripheral circulatory failure, shock, etc.

It is generally believed that aortic and other large atherosclerosis, decreased elasticity and extensibility of the arterial wall, are caused by increased blood pressure in the simple systolic phase. The stiffness of the aorta causes the pressure wave to be reflected faster, causing the superposition of the reflected waves to advance to the systolic phase, resulting in a higher systolic pressure wave. When diastolic, the aorta does not have enough elastic retraction to maintain diastolic blood pressure, which causes diastolic blood pressure to decrease, and the pulse pressure difference increases. Common diseases are: essential hypertension, aortic regurgitation, aortic sclerosis, hyperthyroidism, severe anemia, rheumatic heart disease, syphilitic heart disease, partial congenital heart disease and hypertensive heart disease, bacteria Endocarditis and the like.

an examination

Related inspection

Ambulatory blood pressure monitoring (ABPM) blood pressure

Measuring the pulse pressure, if the pulse pressure difference is less than 30mmHg, it can be determined that the pulse pressure difference is small, if you want to diagnose the disease, you need to check the body, instrument detection, for further diagnosis.

Indirect measurements are used for the measurement of human arterial blood pressure, usually using the assay invented by the Russian physician N. Korotkov. The device consists of an inflatable cuff and a pressure gauge connected to it, and the sleeve is tied to the subject. The upper arm, then pumping to block the blood flow of the brachial artery, slowly release the air inside the cuff, using the stethoscope placed on the radial artery can be heard when the cuff pressure is just less than the brachial blood pressure, the blood flow is over the flattened The vibrational sound caused by turbulence in the arteries (Krottkov, referred to as Coriolis sound) is used to determine the highest pressure during systole, called systolic blood pressure. Continue to deflate, the Coriolis sound increases, and the blood pressure reading measured when the sound becomes low and long, the equivalent of the lowest blood pressure during diastole is called diastolic blood pressure, when deflated into the cuff, the pressure is lower than the diastolic pressure The blood flow smoothly flows through the unobstructed blood vessels, and the Coriolis sound disappears.

Because the specific gravity of mercury is too large, it is difficult for the mercury manometer to accurately and quickly reflect the instantaneous changes of blood pressure in each phase of the heartbeat. Therefore, various sensitive membrane manometers can be used to accurately measure the contraction and diastolic blood pressure. In recent years, various transducers have been used in combination with an oscilloscope to more sensitively measure blood pressure.

National authorities publish normal blood pressure: systolic blood pressure <130 mmHg, diastolic blood pressure <85 mmHg; ideal blood pressure: systolic blood pressure <120 mmHg, diastolic blood pressure <80 mmHg.

Differential diagnosis

Clinical attention should be paid to identify diseases that cause small pulse compression in order to get timely treatment. Common diseases that cause reduced pulse pressure: massive pericardial effusion, constrictive pericarditis, severe mitral stenosis, aortic stenosis, severe heart failure, peripheral circulatory failure, shock, and increased blood viscosity due to obesity Or combined with diabetes, hyperlipidemia and so on.

1 heart failure

1. Pay attention to the cause of heart failure and the presence or absence of symptoms and signs of pulmonary or (and) systemic congestion, and check according to the general routine of cardiovascular disease.

2. Complete venous pressure, erythrocyte sedimentation rate, liver and kidney function tests within 2 days after admission. Long-term low-salt diet or diuretics should be checked regularly for potassium, sodium, chlorine, and magnesium.

3. It is proposed to distinguish left heart, right heart or whole heart failure according to clinical manifestations and examinations, and determine the level of heart failure.

2 hyperlipidemia

In the diagnosis of hyperlipoproteinemia, it is more difficult to determine the value of normal plasma TC. Prospective studies have shown that the incidence of coronary heart disease increases with the TC value, which was previously considered normal and is higher than the TC value for people with a low incidence of atherosclerosis. In addition, some evidence suggests that lowering the average TC (and LDL) levels in American coronary heart disease (CAD) populations may slow CAD progression.

3 diabetes

1, with typical symptoms, fasting blood glucose 126mg / dl (7.0 mmol / l) or postprandial blood glucose 200mg / dl (11.1 mmol / l).

2, there is no typical symptoms, only fasting blood glucose 126mg / dl (7.0 mmol / l) or postprandial blood glucose 200mg / dl (11.1 mmol / l) should be repeated again, still reach the above values, can be diagnosed as diabetes.

3, no typical symptoms, only fasting blood glucose 126mg / dl (7.0 mmol / l) or postprandial blood glucose 200mg / dl (11.1 mmol / l), glucose tolerance test 2 hours blood glucose 200mg / dl (11.1mmol / l) can be diagnosed For diabetes.

When measuring the pulse pressure, if the difference between the systolic pressure and the diastolic pressure is less than 30 mmHg, it can be judged that the pulse compression is small, and the physical examination is further checked, and the instrument is detected, so that the pulse compression caused by the cause is small.

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