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Paradoxical Breathing on Physical Exam Paradoxical breathing is often a sign of breathing problems. It causes the chest to contract during inhaling and to expand during exhaling. DDx includes flail chest and diaphragm paralysis. Dr. Fares Alghamdi @FaresHAlghamdi #Paradoxical #Breathing #PhysicalExam #respiratory #clinical #video #pulmonary #peds #pediatrics