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During an Asthma attack, your bronchioles (tubes that carry air into your lungs) constrict and air cannot pass through them as freely. In order to make up for this loss in cross sectional area, a person needs to breathe harder to get enough oxygen. The way you do that is to expand your thoracic wall with more force (when you breathe, your muscles stretch your rib cage out and air is sucked in through your trachea and into your bronchioles, eventually making its way into your alveoli where gas exchange occurs). This creates a negative pressure in the thoracic cavity at a greater magnitude than normal. Increased negative pressure in the thoracic cavity will result in decreased filling of the left ventricle of your heart because the blood will preferentially remain in the lung due to the negative pressure "sucking" it back as opposed to moving into the left atrium (the left atrium holds the blood before it enters the left ventricle, which is the chamber that pumps blood out to the peripheral parts of your body such as your arms, legs, and head). This decreased end diastolic volume (volume in the ventricle after it has finished filling) is going to result in a lower stroke volume (volume of blood expelled from the heart during contraction). If you have a lower stroke volume, you are not pushing as much blood into your arteries and the pressure will, naturally, be lower than normal. Your body will try to compensate for this decrease in pressure by increasing heart rate (known as the baroreceptor reflex) and by constricting arterioles to increase peripheral resistance, but these efforts are not enough to fully counteract the effects of the pulsus paradoxus. Thus, during an asthma attack your blood pressure will be decreased.

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