Final answer:
The combination of hypotension, jugular venous distension, muffled heart sounds, and pulsus paradoxus suggests cardiac tamponade, a serious condition where fluid compresses the heart. Pulsus paradoxus is confirmed by a significant drop in systolic pressure upon inspiration. Diagnosis requires measuring blood pressure using a sphygmomanometer and stethoscope to listen for Korotkoff sounds.
Step-by-step explanation:
The physical findings of hypotension, jugular venous distension, muffled heart sounds, and pulsus paradoxus are indicative of the clinical condition known as cardiac tamponade. This condition is characterized by the accumulation of fluid in the pericardial space, which can compress the heart and impede its function. Pulsus paradoxus is a specific finding associated with cardiac tamponade and is defined as a decrease in systolic blood pressure of more than 10 mm Hg during inspiration. It is detected by measuring systolic blood pressure during exhalation and comparing it to the pressure during inhalation using a sphygmomanometer and stethoscope to listen for Korotkoff sounds. Upon inspiration, the intrathoracic pressure changes, and a significant drop in systolic pressure indicates the presence of pulsus paradoxus.
To measure blood pressure and detect pulsus paradoxus, the clinician wraps an inflatable cuff around the patient's arm at the level of the heart, inflates the cuff to cut off blood flow, and listens for Korotkoff sounds using a stethoscope. The first Korotkoff sound indicates systolic pressure, and the point at which the last sound is heard marks the diastolic pressure. The presence of pulsus paradoxus along with the other symptoms can lead to the diagnosis of cardiac tamponade, which requires immediate medical attention.