Arterial pulse waveform is composed of percussion wave travelling along artery which is at a much higher speed than the actual passage of blood with a dicrotic notch which represents the closure of the aortic valve.
About
Character
Pulse characteristics Good volume Normal Bounding High output e.g. post exercise, thyrotoxicosis, fever, Hyperdynamic circulation, severe Paget's disease Collapsing pulse Aortic regurgitation or AV fistula. Low diastolic pressure. Wide pulse pressure. Plateau pulse Slow rising small "pulsus parvus" seen with Aortic stenosis. Narrow pulse pressure. Jerky pulse Hypertrophic obstructive cardiomyopathy Pulsus Bisferiens Mixed collapsing and plateau pulse with mixed aortic valve disease Pulsus alternans Alternating large and small beats and suggests severe LV dysfunction Pulsus bigeminus caused by a premature beat before every QRS complex Pulsus paradoxus Normal BP fall with inspiration is exaggerated > 10 mmHg. Feel pulse weakens with inspiration. Consider Cardiac Tamponade, pericardial constriction and acute severe asthma where inspiration will affect cardiac filling. Pulse weakens during inspiration. Absent dissection if aorta with ipsilateral subclavian involved, arterial thrombosis or embolism in subclavian or brachial or may be seen post catheterisation (angiography now done via radial artery), Takayasu's disease
Radiofemoral delay Suggests Coarctation of aorta. Be sure to check blood pressure at arm and legif suspicious.
Rate (normal resting adult 60-90 bpm)
Rhythm
Regular Sinus Rhythm, Sinus tachycardia, Sinus bradycardia, Atrial flutter with 2:1 or 3:1 block, Complete heart block (slow!)
Regularly irregular Bigemini (normal beat followed by ectopic), Mobitz type II block
Irregularly irregular Atrial fibrillation (commonest abnormality) , SR with multiple ectopics
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Arterial Pulse assessment
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