Arm to arm BP

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This topic contains 2 replies, has 3 voices, and was last updated by Profile photo of Jennster Jennster 1 year, 4 months ago.

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    Profile photo of Jennster

    Hey everyone,
    Recently I had an acute situation on a colleagues patient. I was helping her. We did an EKG which showed AFib. My colleague (nurse) did BP on both the patients arms and there was a big difference. One was 160/90 and the other was 128/70 (I forget which arm was what). She is more experienced and recognized this as a much more serious situation. This was new to me. I did not know that could indicate anything, though I can recall seeing physicians do this, but I don’t know what it means.
    I’ve been researching and it seems to indicate a reduction in blood flow, but this all seems to be in a more chronic setting, and I cannot find anything about this that would be especially useful in an acute setting.
    Can anyone shed more light on this please.


    When you see a difference in blood pressures from side to side, it is normally a chronic condition (some studies suggest PAD and other things which can lead to bigger problems) but a sudden change in blood pressures between arms, especially if they have just experienced a sudden pain, is a Thoracic Aortic Dissection.

    Bilateral BPs is kind of like D-dimers. If they come back normal, it makes the doctor happy and if no other obvious things come back, they will be sent home (or admitted for serial tests) but if either come back positive (BPs that are >20 points from side to side) they are likely to get a chest angio. D-dimers will lead them down the PE pathway, while BP differences will lead them down the Thoracic Aortic Dissection pathway.

    Profile photo of Jennster

    Thanks, Jason. I appreciate your time and knowledge.

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