Abnormal Finding
Less than 60/min
(Myxedema, heart block, raised IC tension, obstructive jaundice)
Tachycardia: Faster than 100/min.
(Sinus tachycardia, PAT, atrial flutter, ventricular tach)
Rhythm
(Sinus arrhythmia, extra systoles,
atrial fib, pulses bigemini)
Alternating weak and strong pulse:
Normal beat
alternating with extra systole (Dig toxicity)
Pulses alternans: Normal beat
alternating with low amplitude beat
Amplitude
Aortic
stenosis)
Large bounding pulse: Water hammer pulse:
(Aortic insufficiency, high output states, slow heart rates)
Double systolic peak: Bisferiens pulse
(Aortic
regurgitation)
Decrease in amplitude during inspiration:
Paradoxical pulse Exaggerated in (Pericardiac
tamponade,
obstructive lung disease)
Compare
- Missing or feeble on one side:
(Prior
cath, Takayasu's disease, subclavian steel syndrome)
Grading Pulse
- 4=Normal
- 3=Slightly diminished
- 2=About half
- 1=Barely palpable
- 0=Absent