Pulse deficit4/17/2023 Pulsus paradoxus can be measured using a sphygmomanometer and is present when the first Korotkoff sound appears only during expiration. Examination of pulse includes assessment of its rate (rapid, slow), rhythm (regular, irregular), amplitude (can be equated with pulse pressure high amplitude, low amplitude), and duration of the systolic wave (quick, delayed).ġ) Low-amplitude delayed pulse (pulsus parvus et tardus): Aortic stenosis.Ģ) Thready pulse (quick, very fine): Shock, rarely fever or cardiac tamponade.ģ) Hypokinetic pulse: Reduced left ventricular stroke volume (heart failure, impaired left ventricular outflow), increased peripheral vascular resistance.Ĥ) Quick high-amplitude pulse (pulsus magnus et celer): Aortic regurgitation, patent ductus arteriosus, hyperdynamic circulation.ĥ) Hyperkinetic pulse: Aortic regurgitation, patent ductus arteriosus, hyperdynamic circulation, hypertrophic cardiomyopathy with obstruction of the left ventricular outflow tract ( LVOT), mitral regurgitation.Ħ) Bisferious pulse (pulsus bisferiens 2 strong systolic peaks): Hypertrophic cardiomyopathy with obstruction of the LVOT, combination of aortic regurgitation and stenosis.ħ) Dicrotic pulse (one peak during systole and another at the beginning of diastole): Cardiac tamponade, severe heart failure, hypovolemic shock it may rarely occur in healthy young individuals.Ĩ) Paradoxical pulse (pulsus paradoxus): Normally blood pressure declines during inhalation (increase in blood inflow and volume of the right atrium with decreased compliance of the left atrium and subsequent decreased blood flow to the left ventricle) such decreases are 10 mm Hg in systolic blood pressure. The following arteries are palpated (bilaterally) in adults: common carotid, radial, brachial, femoral, popliteal, dorsalis pedis, and tibialis posterior. Pulse is examined using palpation and auscultation of superficial arteries. Pulse is the rhythmic expansion of the arterial wall that is dependent on myocardial contractions and elasticity of the wall. Authors: Wojciech Szczeklik, Wiktoria Leśniak
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