Korotkoff’s sounds-Pathological Variations


Korotkoff’s sounds-Pathological Variations

1. Hypertension: it is a persistent rise in blood pressure above the normal limit for the age and sex of the individual. A number of readings should be taken before declaring an individual hypertensive.

Hypertension can be

a. Primary or essential hypertension.

b. Secondary (due to a known cause) hypertension

Eg: Arterial - Arteriosclerosis

Coarctation of aorta

Renal artery stenosis

Renal - Acute glomerulonephritis


Polycystic kidney Disease

Endocrine - Phaechromocytoma

Cushing’s syndrome

Conn’s syndrome

2. Hypotension: it is a persistent fall in blood pressure below the normal for the age and sex of the individual. Eg: Trained athlets, myocardial infarction, circulatory shock (haemorrhage, septicaemia)


1. The subject should be mentally and physically relaxed before determining the blood pressure.

2. The mercury level should be zero to start with, each time the reading is taken.

3. The cuff should neither be too tight nor too loose.

4. The apparatus should be kept at the level of the heart, otherwise the reading will vary due to the effect of gravity.

5. The manometer scale should be placed at the same level as the observer’s eyes to prevent parallax error.

6. Keep the manometer scale facing away from the subject.

7. The cuff should not be kept inflated for long periods.

8. Inflation should be quick and deflation should be slow.

Ausculatory gap: Occasionally when the blood pressure is determined byauscultatory method, the Korotkoff’s sound appear first, then disappear completely to reappear after a gap. This gap is called auscultatory gap or silent gap. This phenomenon is seen in certain patients with hypertension. This leads to errors in systolic pressure recordings, as the reapperance of the sound may be taken as the systolic blood pressure. To avoid this, the blood pressure is determined by PALPATORY method first, to get an approximate idea about systolic pressure and then by auscultatory method.



Name: Age: Sex: Occupation: Address:

B.P. in recumbent posture = Palpatory: Auscultatory:

B.P. in erect posture = Palpatory: Auscultatory:

B.P. in sitting = Palpatory: Auscultatory:

B.P.Afterexercise = Palpatory: Auscultatory:


How is blood pressure controlled?






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