Absence of paradoxical pulse in patients with cardiac tamponade and atrial septal defects

Five patients with atrial septal defect and proved cardiac tamponade had neither paradoxical pulse nor the inspiratory reduction of left ventricular internal dimension associated with this sign. It is assumed that equilibration of flow across the atrial septal defect prevented paradoxical pulse. Patients with a large atrial septal defect and tamponade do not manifest a paradoxical pulse.