II. Definitions

  1. Pulse Pressure
    1. Difference between systolic pressure and diastolic pressure
    2. Represents the force of cardiac contraction

III. Exam: Normal Pulse Pressure

  1. Range: 30-40 mmHg

IV. Causes: Wide (high) Pulse Pressure (>40 mmHg)

  1. Pathophysiology in Isolated Systolic Hypertension
    1. Suggests reduced large artery vascular compliance
    2. Best Blood Pressure marker for cardiovascular risk
  2. Causes
    1. Isolated Systolic Hypertension
    2. Aortic Regurgitation
    3. Thyrotoxicosis
    4. Patent Ductus Arteriosus
    5. Arteriovenous Fistula
    6. Beriberi heart
    7. Aortic Coarctation
    8. Anemia
    9. Emotional state

V. Causes: Narrow Pulse Pressure (<30 mmHg)

  1. Pathophysiology in Hypovolemic Shock
    1. Sympathetic response to decreased circulating Blood Volume
    2. Diastolic Blood Pressure increase without systolic Blood Pressure increase
  2. Causes
    1. Hypovolemic Shock or Hemorrhagic Shock
      1. May predict circulatory collapse in Trauma with Hemorrhage
      2. Prehospital Narrow Pulse Pressure predicts severe Trauma and need for aggressive Resuscitation
      3. Interpret in combination with Trauma Evaluation and other markers (Hypotension, Shock Index)
      4. Schellenberg (2021) J Surg Res 268:284-90 [PubMed]
    2. Tachycardia
    3. Severe Aortic Stenosis
    4. Constrictive Pericarditis
    5. Pericardial Effusion
    6. Ascites

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Related Studies

Ontology: Narrow pulse pressure (C0240840)

Concepts Finding (T033)
SnomedCT 58283004
Italian Pressione del polso diminuita, Pressione del polso ristretta
English Pulse Pressure Narrow, Narrow arterial pulse pressure, narrowed pulse pressure, narrowed pulse pressure (physical finding), Pulse pressure decreased, narrowed pressure pulse, narrowing pressure pulse, narrow pulse pressure, decreasing pressure pulse, Pulse pressure narrow, Narrow pulse pressure, Narrow arterial pulse pressure (finding)
Japanese 脈圧低下, ミャクアツテイカ, 脈圧狭小, ミャクアツキョウショウ
Czech Pulzní tlak snížený, Pulzní tlak úzký
Hungarian Pulzus nyomás csökkent, Pulzusnyomás szűk
Dutch polsdruk nauw, polsdruk verlaagd
French Pression du pouls restreinte, Pression du pouls diminuée
German Pulsdruck eng, Pulsdruck erniedrigt
Spanish Presión del pulso estrecha, pulso parvus, pulso pequeño (hallazgo), pulso pequeño, Presión disminuida del pulso
Portuguese Pressão de pulso estreita, Tensão diferencial diminuída

Ontology: Pulse Pressure (C0949236)

Definition (NCI_CDISC) The change in systolic to diastolic pressure which produces a pulse.
Definition (NCI) The force of a heart contraction measured by the difference between the diastolic and systolic blood pressure measurements.
Definition (MSH) Difference between systolic and diastolic pressures.
Concepts Organism Function (T040)
MSH D001794
English Pulse pressure, pressures pulse, pulse pressure, pressure pulse, Pressure, Pulse, PULSEPR, Pulse Pressure
French Pression pulsée
German Blutdruck-Amplitude, Pulse Pressure, Pulsdruck
Italian Pressione arteriosa differenziale
Czech pulsní tlak, pulzní tlak
Norwegian Pulstrykk