Korotkoff Sounds - The Improbable also Occurs

Abstract

Very few discoveries have had such a large impact on and relevance to clinical medicine as the noninvasive measurement of the diastolic blood pressure. A number of gifted physiologists and clinicians were ineffectively in search of a noninvasive method to determine the diastolic pressure. Nonetheless, the quantification of the diastolic BP was not achieved by any of these clinical or physiological researchers, but by an unlikely and unexpected figure: Nikolai Sergeevich Korotkoff (1874-1920), a young Russian army surgeon, working under precarious conditions in the hardship of diverse wars. It is easy to dismiss the achievement of Korotkoff as a serendipitous discovery, similar to that of Alexander Fleming in the discovery of penicillin. However, Nassim N. Taleb's recent black swan theory may serve to illustrate his discovery in a new and, perhaps, surprising way.

Blood Pressure: The History and Development of Monitoring Modalities

“…However, Korotkoff's technique offered a crucial advancement in BP measurement by using a stethoscope to listen for the sounds of blood flowing through the artery, ultimately providing more valid and reliable measures of both SBP and DBP. 17 The Korotkoff auscultatory method involves compression of the brachial artery and auscultation over the antecubital fossa to determine the SBP and DBP. Although true MAP is obtained using invasive monitoring, it can also be calculated based on a physiologically sound formula that uses SBP and DBP obtained during auscultation.…”

Stethoscope - Over 200 years

“…The stethoscope was important for measuring blood pressure. Prior to its introduction, the systolic blood pressure could be measured by the Italian, Scipione Riva-Rocci's method from 1896, where the occlusion cuff was associated with a mercury manometer [14]. Here, palpation had to determine when the pulse ceased at increasing cuff pressure, similar to the systolic BT.…”

Avaliação do desempenho de dois aparelhos automáticos de medida da pressão arterial com ou sem alteração do ritmo cardíaco

“…A esfigmomanometria teve início com o aparelho desenvolvido por Riva Rocci em 1896 e a ausculta dos sons de Korotkoff em 1905, contribuição do cirurgião russo Nicolai Sergievic Korotkoff que demonstrou que o pulso poderia ser auscultado durante a deflação do manguito 20, [24][25] Na concentração de 3,5 µg/dL já podem surgir sintomas, como parestesia, ataxia, alterações auditivas, disartrias e até mesmo morte 29 .…”