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Types of Arterial pulses
The pulse is a wave form that is felt by fingers and produced by
cardiac systole which travels through the peripheral arterial tree
in peripheral direction at a rate more faster than that of blood
Anacrotic Pulse (Pulsus Tardus):
Low amplitude pulse with Slow rise and slow fall
Duration of pulse is prolonged
Seen In aortic stenosis
Dicrotic Pulse:(Pulsus Dicrotius)
It has two palpable waves with One peak in systole, one in
diastole.It due to a very low stroke volume with decreased
LVF, Dilated cardiomyopathy
Collapsing or Water hammer pulse
Large volume pulse with Rapid upstroke and rapid down
Rapid up stroke is because of increased stroke volume
Rapid downstroke is due to decrease in peripheral
resistance and diastolic leak back into left ventricles.
Best felt in radial artery with patient’s arm elevated
Hyperdynamic states: Fever, Anaemia, Thyrotoxicosis,
pregnancy and AV fistula
It is single pulse wave with two peaks in systole
d/t ejection of rapid jet of blood through aortic valve
Best felt in brachial and femoral artery
AS + AR
HOCM(Hypertrophic obstructive cardiomyopathy)
Small volume pulse like anacrotic pulse but anacrotic wave is
It occurs as a result of a reduction in left ventricular stroke
volume or decrease in systemic arterial pressure .
Severe Hypotension (Shock)
Severe AS PS
Alternate large and small volume pulse,with a normal rhythm.There is a
difference of 10-40 mmHg in systolic pressure between beats .
Due to alternate left ventricular contractile force ie,the ventricles beats
strongly ,then weakly ,alternating with each other.
A Pulse wave with normal beat followed by pre mature beat and
compensatory pause,thereby producing irregular rhythm .
It is caused by coupled ectopic beats ie,an ectopic beat following each
regular beat .
Exaggerated decrease in strength of arterial pulse during
inspiration, Inspiratory fall of SBP >10mmHg
The radial pulse gets smaller in volume with inspiration and
larger in volume with expiration .
In this during inspiration the increased right ventricular
volume results in bulging of interventricular septum into left
ventricular cavity.This results in reduction in left ventricular
volume leading to a further reduction in cardiac output.This
exaggerats the normal inspiratory reduction in blood
pressure ,allowing it to exceed 10mmHg.
Superior vana cava obstruction
Reverse pulsus paradoxus: It is an inspiratory rise in
Hypertrophic obstructive cardiomyopathy
Intermittent positive pressure ventilation