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Arterial Pulse
Aka: Arterial Pulse, Pulse, Abnormal Arterial Pulsation, Abnormal Pulse, Water-Hammer Pulse, Water Hammer Pulse, Abrupt Pulse, Pulsus parvus et tardus, Pulsus Alternans, Pulsus Bisferiens, Double Pulse, Asymmetric Pulse
- See Also
- Heart Rate
- Exam: Locations
- Peripheral arterial pulsation
- Arm
- Radial pulse (wrist)
- Ulnar pulse (wrist)
- Brachial pulse (antecubital)
- Foot
- Posterior tibial pulse
- Dorsalis pedis pulse
- Central arterial pulsation
- Carotid pulse (Neck)
- Femoral pulse (Groin)
- Exam: Pulse loss in Hypotension
- In Hypotension, radial pulse is lost first, then femoral and then carotid
- Systolic Blood Pressure at which each Blood Pressure is lost is variable per patient
- Old ATLS guidelines (see below) appeared to overestimate the systolic Blood Pressure at which pulse was lost by at least 10 mmHg
- Old ATLS estimates - deprecated from current ATLS guidelines (cutoff was overestimated by at least 10 mmHg)
- Radial pulse present if systolic Blood Pressure >80 mmHg
- Femoral pulse present if systolic Blood Pressure >70 mmHg
- Carotid pulse present if systolic Blood Pressure >60 mmHg
- References
- Deakin (2000) BMJ 16:321(7262): 673-4 [PubMed]
- Findings: Abnormal
- See Arrhythmia for abnormal rate or rhythm
- Water-Hammer Pulse: Large amplitude, rapidly rising (Abrupt Pulse)
- Hypertrophic Cardiomyopathy
- Aortic Regurgitation
- Mitral Regurgitation (severe)
- Patent Ductus Arteriosus
- Pulsus parvus et tardus (Small amplitude, slow rising)
- Definitions
- Parvus: Low volume pulse
- Tardus: Slow rate of rise to carotid or brachial pulse - nudge instead of a strong tap
- Causes
- Aortic Stenosis
- Diminished Cardiac Output
- Pulsus Alternans (alternating strong and weak pulse)
- Left Ventricular Systolic Dysfunction
- Pulsus Paradoxus (Diminished pulse on inspiration)
- Cardiac Tamponade
- Congestive Heart Failure (severe)
- Chronic Obstructive Pulmonary Disease (severe)
- Asthma
- Constrictive Pericarditis
- Pulsus Bisferiens (Double-peak pulse)
- Aortic Regurgitation
- Hypertrophic Cardiomyopathy
- Asymmetric Pulse
- Central Causes
- Aortic Dissection
- Aortic Coarctation
- Subclavian Steal Syndrome
- Takayasu Arteritis
- Peripheral Causes
- Peripheral Arterial Disease (to the point of Critical Limb Ischemia)
- Compartment Syndrome (or other acute peripheral vascular compromise)
- References
- Chizner (2002) Dis Mon 48:7-98 [PubMed]
- Giese (2007) Am Fam Physician 75:1008-14 [PubMed]