Sources of errors in blood pressure measurement Systolic blood pressure ≥ 130 mm Hg and/or a diastolic blood pressure ≥ 80 mm Hg.See also “ Normal vital signs at rest” for all age groups.Systolic blood pressure Interpretation: When deflating the cuff, the pressure at which Korotkoff sounds appear marks systolic BP, and the pressure at which Korotkoff sounds disappear marks diastolic BP.Origin: turbulent blood flow through a brachial artery that is partially compressed by the inflated arm cuff of a sphygmomanometer.Definition: sounds heard when auscultating over the brachial artery during sphygmomanometry.Determine the systolic and diastolic blood pressure value (e.g., auscultatory method using Korotkoff sounds over the brachial artery ).Ģ4-hour ambulatory blood pressure measurement can be helpful in establishing the average and peak blood pressure values during daily activities.Record the pressure in both arms and note any differences.Ask the patient to rest the arm on a horizontal surface at the level of the heart.The patient should sit for several minutes before blood pressure is measured.Jugular venous pressure (see “ Clinical assessment of jugular venous pressure ”).Hypertensive retinopathy (ophthalmologic examination).Xanthelasmas, arcus lipoides corneae ( dyslipidemia ).Palms: Osler nodes, Janeway lesions (see “ Clinical features of infective endocarditis ”).Central cyanosis (see features of “ Cyanotic congenital heart defects ” and “ Congestive heart failure ”).Features of rheumatic fever: migrating polyarthritis, erythema marginatum, subcutaneous nodules.Syndromic features (e.g., in trisomy 21, trisomy 18 associated with congenital heart defects).Palpitations : an unpleasant awareness of one's own heartbeat can feel like a fluttering or pounding in the chest.Chest pain (see “ Cardiovascular causes of chest pain ”).
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