CAROTID ARTERY PULSE

• Pulsus parvus: Weak upstroke due to decreased stroke volume (hypovolemia, LV failure, aortic or mitral stenosis [MS]) (Fig. 112-1)
• Pulsus tardus: Delayed upstroke (aortic stenosis [AS])
• Bounding (hyperkinetic) pulse: Hyperkinetic circulation, aortic regurgitation, patent ductus arteriosus, marked vasodilation
• Pulsus bisferiens: Double systolic pulsation (aortic regurgitation, hypertrophic cardiomyopathy)
• Pulsus alternans: Regular alteration in pulse pressure amplitude (severe LV dysfunction)
• Pulsus paradoxus: Exaggerated inspiratory fall (>10 mmHg) in systolic bp (typical of pericardial tamponade; also seen in severe obstructive lung disease, massive pulmonary embolism, tension pneumothorax)

FIGURE 112-1

Carotid artery pulse patterns.

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