Quieter Korotkoff sounds when taking blood thinners?

[berkeman]

I have a patient that I have known for a long time, and her Korotkoff sounds have always been pretty typical in volume when I've taken her blood pressure. But after a recent medical incident, her doctor has put her on a long-term blood thinner medication.

I was taking her BP a couple of days ago, and her Korotkoff sounds were so faint that I had to end up just taking the BP by palpation. Her systolic pressure was still typical for her (around 126/P), so I don't think that was the issue with the sounds being so quiet. Does anybody know if using blood thinners can result in quieter Korotkoff sounds when auscultating BP? My Google-foo is failing me...

 

[jim mcnamara]

I find nothing on Medline, JAMA or NIH directly. Also tried drug names and "brands", examples: Warfarin, Xarelto, Heparin, and Dabagatran. Zilch.

The bad news is there are hits for other causes. As in: it is definitely possible you should consider getting another medical opinion before you write it off. ...like you did not already know this

 

[Tom.G]

From a non-medical standpoint, it sounds like there is reduced blood flow - perhaps from an upstream restriction. With normal vasculature downstream of a constriction, this would also effectively implement a low-pass filter. (in electrical or mechanical terms, a resistance followed by a compliance.)
Probably @boneh3ad or @Chestermiller can give better insight though.

 

[berkeman]

The bad news is there are hits for other causes. As in: it is definitely possible you should consider getting another medical opinion before you write it off. ...like you did not already know this

Yeah, I need to look into other causes. Decreased vascular compliance looks to be a candidate:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800516/

Except for the quick onset of it in this patient. I'll check her a few more times to be sure, and have her mention it to her doc. Thanks for the help guys.

 

[256bits]

But after a recent medical incident, her doctor has put her on a long-term blood thinner medication.

Blood thinner doesn't really thin the blood, it limits the ability to clot, so that shouldn't have a direct effect.
( Perhaps, in addition her diet has changed, and she is on a more liquid intake, which should find its way into the bloodstream )

Have you investigated the
https://en.wikipedia.org/wiki/Auscultatory_gap
as a route to your findings.