Old Dominion Heather Posted June 23, 2008 Share Posted June 23, 2008 What would it mean if your blood pressure numbers were higher for the bottom number than the top number? For example, if your blood pressure were something like 90/110? This happened with my mom this morning when she went to the hospital. Frankly, I am very concerned. She woke up vomiting (sorry) and has been in Russia with a blood infection. She is on two antibiotics, pain meds and now phenagrin for the nausea. The took a sample to culture and find out what type of infection she has. The doctor told her that MRSA was only about a 20% chance. They sent her home and told her to rest. Quote Link to comment Share on other sites More sharing options...
GraceinMD Posted June 23, 2008 Share Posted June 23, 2008 I'd think someone misunderstood something.... It can't happen that way (the diastolic (bottom) being higher than the systolic (top)), because the first number is the first sound heard as you release the blood pressure cuff, and the second number is the last sound you hear (there are five). Therefore, the second number CAN'T be higher than the first number. (Clear as mud?) Or, to simply cut-and-paste from Wikipedia, which has a reasonable explanation: If the pressure is dropped to a level equal to that of the patient's systolic blood pressure, the first Korotkoff sound will be heard. As the pressure in the cuff is the same as the pressure produced by the heart, some blood will be able to pass through the upper arm when the pressure in the artery rises during systole. This blood flows in spurts as the pressure in the artery rises above the pressure in the cuff and then drops back down, resulting in turbulence that results in audible sound. As the pressure in the cuff is allowed to fall further, thumping sounds continue to be heard as long as the pressure in the cuff is between the systolic and diastolic pressures, as the arterial pressure keeps on rising above and dropping back below the pressure in the cuff. Eventually, as the pressure in the cuff drops further, the sounds change in quality, then become muted, then disappear altogether. As the pressure in the cuff drops below the diastolic blood pressure, the cuff no longer provides any restriction to blood flow allowing the blood flow to become smooth again with no turbulence and thus produce no further audible sound. Korotkoff actually described 5 types of Korotkoff sounds: The first Korotkoff sound is the snapping sound first heard at the systolic pressure. The second sounds are the murmurs heard for most of the area between the systolic and diastolic pressures. The third and- the fourth sound, at pressures within 10 mmHg above the diastolic blood pressure were described as "thumping" and "muting". The fifth Korotkoff sound is silence as the cuff pressure drops below the diastolic blood pressure. Traditionally, the systolic blood pressure is taken to be the pressure at which the first Korotkoff sound is first heard and the diastolic blood pressure is the pressure at which the fourth Korotkoff sound is just barely audible. However, there has recently (2000 onwards) been a move towards the use of the 5th Korotkoff sound (i.e. silence) as the diastolic blood pressure, as this has been felt to be more reproducible. Anyway, if your mom's BP is low, there are whole bunch of reasons why that could be. Infection, dehydration, meds, etc., etc., etc. Hope she feels better soon - she must be exhausted from her recent ordeal! Quote Link to comment Share on other sites More sharing options...
Sharon in SC Posted June 23, 2008 Share Posted June 23, 2008 I'd think someone misunderstood something....the second number CAN'T be higher than the first number. What she said. :) I, too, trust your mom feels better soon! Quote Link to comment Share on other sites More sharing options...
kalanamak Posted June 23, 2008 Share Posted June 23, 2008 Sounds like a automated cuff. I once got a BP of 60/40 on a corpse. Quote Link to comment Share on other sites More sharing options...
Old Dominion Heather Posted June 23, 2008 Author Share Posted June 23, 2008 Ok, thanks! : ) I feel better. She must have been totally out of it this morning. She told me this twice and said that the nurse pointed it out to the doctor. Weird. I wonder what she misunderstood. Quote Link to comment Share on other sites More sharing options...
GSMP Posted June 24, 2008 Share Posted June 24, 2008 Maybe she reversed it and what stood out was that the numbers were so close....which is also dangerous. The Doctors don't like the numbers getting close...... Quote Link to comment Share on other sites More sharing options...
summer Posted June 24, 2008 Share Posted June 24, 2008 she remembered it wrong because that is not possible. The first number is the higher pressure and the 2nd number the lower pressure. They would have to be pumping in reverse to be like that..and I don't think it is possible to pump in reverse. Quote Link to comment Share on other sites More sharing options...
Cami in UT Posted June 24, 2008 Share Posted June 24, 2008 Sounds like a automated cuff. I once got a BP of 60/40 on a corpse. :lol::lol::lol: I'm laughing so hard now. Thanks for the good laugh. Quote Link to comment Share on other sites More sharing options...
GraceinMD Posted June 24, 2008 Share Posted June 24, 2008 I once got a BP of 60/40 on a corpse. Which begs the question, "Why were you checking the BP of a dead person?" (Just kidding!) Quote Link to comment Share on other sites More sharing options...
Old Dominion Heather Posted June 24, 2008 Author Share Posted June 24, 2008 Maybe she reversed it and what stood out was that the numbers were so close....which is also dangerous. The Doctors don't like the numbers getting close...... Yeah... I am thinking it must have been something like this. Actually, not I am kind of concerned because she totally was convinced... and this is not someone who gets things wrong very often. She must have been pretty doped up. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.