Pulses

Pulsus parodoxus

• greater than the normal (10 mmHg) fall in systolic blood pressure during inspiration → faint or absent pulse in inspiration
• severe asthma, cardiac tamponade

Slow-rising/plateau

• aortic stenosis

Collapsing

• aortic regurgitation
• patent ductus arteriosus
• hyperkinetic (anaemia, thyrotoxic, fever, exercise/pregnancy)

Pulsus alternans

• regular alternation of the force of the arterial pulse
• severe LVF

Bisferiens pulse

• 'double pulse' - two systolic peaks
• mixed aortic valve disease

'Jerky' pulse

• hypertrophic obstructive cardiomyopathy*

*HOCM may occasionally be associated with a bisferiens pulse