Arterial pulse abnormalities

Pulsus Paradoxus

  1. Pulse volume decreases during inspiration and becomes normal in expiration.
  2. First described in costrictive pericarditis, but it is usually rare in this condition.

Typical of

  • Pericardial tamponade.
    Severe airway obstruction.
    SVC obstruction.

Pulsus Alternans

  1. Alternating small and large volume pulses.
  2. Seen in LVF

Reverse Pulsus paradoxus

  1. Rise in systolic BP>15mm during inspiration.
  2. Seen in:
  • Hypertrophic cardiomyopathy
  • Patients having LVF on Positive pressure ventilation.

Dicrotic Pulse

  1. Two palpable waves one each in systole and diastole
  2. Seen in conditions of  very low stroke volume.
  3. eg:Dilated cardiomyopathy.

Bisferiens pulse

  1. Two peaks, both in systole.
  2. Typical of AR(with or without AS)
  3. HOCM
  4. Best felt in peripheral arteries, radial or brachial.

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