Pulses (character & volume) Flashcards
1
Q
What are the 5 classic types of abnormal pulse character?
A
- Slow-rising pulse
- Collapsing pulse
- Biphasic pulse - pulsus bisferiens
- Alternating pulse - pulsus alternates
- Pulsus paradoxus
2
Q
What are the characteristics of a SLOW-RISING pulse?
A
- Weak
- Gradual UPSLOPE that PEAKS IN LATE SYSTOLE
- Characteristic of severe AORTIC STENOSIS
3
Q
Where is the best place to assess pulse character?
A
Carotid artery
It is best to assess close to the heart - the pulse becomes ‘damped’ the further it is from the heart
4
Q
What are the characteristics of a COLLAPSING pulse?
A
- EARLY peak with SHARP DESCENT
- Only characteristic pulse tested at the RADIAL artery
- Raise patient’s arm above their head while palpating the pulse.
- Characteristic of AORTIC REGURGITATION
5
Q
What are the characteristics of a BIPHASIC pulse?
A
- DOUBLE PEAK
- Found in MIXED aortic stenosis & regurgitation
- Found in HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY
6
Q
What are the characteristics of an ALTERNATING pulse?
A
- Alternate beats are STRONG then WEAK
- Found in SEVERE LV SYSTOLIC DYSFUNCTION
7
Q
What are the characteristics of a PULSUS PARADOXUS?
A
- Exaggeration of the normal variation in pulse volume with respiration i.e. significant DECREASE on INSPIRATION and INCREASE on EXPIRATION.
- Seen in CARDIAC TAMPONADE, severe ASTHMA, COPD
8
Q
When would you see a LARGE VOLUME pulse?
A
INCREASED cardiac output: - Pregnancy - Anaemia - Thyrotoxicosis - Sepsis AORTIC REGURGITATION
9
Q
When would you see a SMALL VOLUME pulse?
A
REDUCED cardiac output: - Severe LVF - Severe aortic stenosis Reduced CIRCULATING VOLUME - Haemorrhage - Dehydration
