![]() ![]() The auscultatory gap is most likely to appear in the obese arm, especially if the physician pumps up the cuff slowly and traps a great deal of blood in the arm’s venous compartment. BP 200/110 with the auscultatory gap from 170 to 140.Īuscultatory gap has been found to occur due to venous pooling of blood. When recording a blood pressure with an auscultatory gap, always list your complete findings. Also if you, inflate the cuff to 200, you may read 170 as the diastolic pressure which is the beginning of auscultatory gap. You inflate the cuff to 170 and hear nothing until the manometer reaches 140, which you presume is the systolic pressure. The patient’s actual systolic pressure is 200 with a gap from 170 to 140 and a diastolic of 110. Overestimation of diastolic blood pressure.Underestimation of systolic blood pressure.It can result in following erroneous blood pressure reading: The auscultory gap occurs when the first Korotkoff sound fades out for about 20-50 mmHg only to return. Phase 1 (K1): Clear tapping sounds representing systolic pressure Phase 2 (K2): Onset of swishing sound or murmur Phase 3 (K3): Loud slapping sound Phase 4 (K4): Muffled Tones sounds representing diastolic pressure Phase 5 (K5): Tones ceaseĪn auscultatory gap also called as silent gap is the interval of pressure where korotkoff sounds indicating true systolic pressure fade away and reappear at a lower pressure point during the manual measurement of blood pressure by auscultatory method. As the pressure is further gradually lowered down, following korotkoff sounds are heard: 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. The jet causes turbulence in the vessel beyond the cuff, and this sets up the vibrations heard through the stethoscope.Īs long as the pressure in the cuff is higher than the systolic blood pressure of the patient, blood doesn’t jet through the completely occluded artery, hence no sound is heard. These sounds are called Korotkoff sounds believed to be caused mainly by blood jetting through the partly occluded vessel. When the cuff pressure is great enough to close the artery during part of the arterial pressure cycle, a sound then is heard with each pulsation. This period when no sound is heard is called as auscultatory gap. Sometimes during manual blood pressure measurement by auscultatory method, after a few initial tapping sounds, no sound is heard for a variable duration and then the sounds are heard again. ![]()
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