Cardiovascular Medicine Book

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Blood PressureAka: BP Examination, Korotkoff Sound

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  1. See Also
    1. Hypertension
    2. Hypertension Criteria
  2. Preparation: Positioning of Blood Pressure Cuff
    1. Cuff applied directly over skin (not through clothes)
      1. Clothes artificially raises blood pressure
    2. Center inflatable bladder over brachial artery
    3. Position lower cuff border 2.5 cm above antecubital
    4. Patient's arm slightly flexed at elbow
    5. Position stethoscope bell over brachial artery
  3. Equipment: Blood pressure cuff size
    1. Poor cuff fit results in inaccurate blood pressure
      1. Undersized cuff artificially raises blood pressure
      2. Oversized cuff artificially lowers blood pressure
    2. Pediatric Cuff size
      1. Minimum Cuff Width
        1. Width >2/3 length of upper arm
        2. Width >40% of arm circumference
      2. Minimum Cuff length
        1. Bladder nearly encircles arm
        2. Bladder length 80-100% of circumference
    3. Adult Cuff size
      1. Cuff Width: 40% of limb's circumference
      2. Cuff Length: Bladder at 80% of limb's circumference
      3. Indications for large cuff or thigh cuff
        1. Upper arm circumference >34 cm
      4. Indications for forearm cuff (with radial palpation)
        1. Upper arm circumference >50 cm
  4. Technique: BP measurement
    1. Wait 5 minutes of rest before checking blood pressure
    2. Check blood pressure in right arm, while seated
    3. Take Blood Pressure at heart level
    4. Inflate cuff rapidly to level above suspected SBP
    5. Deflate cuff slowly at a rate of 2-3 mmHg per second
    6. Listen for auditory vibrations from artery (Korotkoff)
      1. Systolic Blood Pressure: Onset of consecutive sounds
      2. Diastolic Blood Pressure: Disappearance of sounds
  5. Technique: Obtain Multiple Blood Pressure measurements
    1. Validation of abnormal readings
      1. Recheck blood pressure twice more at same visit
    2. Aortic Coarctation
      1. Left and right arm, and one lower extremity
    3. Orthostatic Hypotension
      1. Check Blood Pressure and Pulse, Supine and Standing

Blood Pressure (C0005823)

Definition (MSH)PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.
Definition (CSP)force exerted by the blood on the walls of the arteries and other vessels.
Definition (NCI)The pressure of the circulating blood against the walls of the blood vessels.
ConceptsOrganism Function (T040)
EnglishBlood Pressure, BP
Spanishpresión arterial, presión sanguínea, presion arterial, presion sanguinea, tensión arterial, tension arterial
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Korotkoff sounds (C0277892)

ConceptsFinding (T033)
EnglishKorotkoff sounds
Spanishruidos de Korotkoff
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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