Pulsus

WikiDoc Resources for Pulsus

Articles

Most recent articles on Pulsus

Most cited articles on Pulsus

Review articles on Pulsus

Articles on Pulsus in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Pulsus

Images of Pulsus

Photos of Pulsus

Podcasts & MP3s on Pulsus

Videos on Pulsus

Evidence Based Medicine

Cochrane Collaboration on Pulsus

Bandolier on Pulsus

TRIP on Pulsus

Clinical Trials

Ongoing Trials on Pulsus at Clinical Trials.gov

Trial results on Pulsus

Clinical Trials on Pulsus at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Pulsus

NICE Guidance on Pulsus

NHS PRODIGY Guidance

FDA on Pulsus

CDC on Pulsus

Books

Books on Pulsus

News

Pulsus in the news

Be alerted to news on Pulsus

News trends on Pulsus

Commentary

Blogs on Pulsus

Definitions

Definitions of Pulsus

Patient Resources / Community

Patient resources on Pulsus

Discussion groups on Pulsus

Patient Handouts on Pulsus

Directions to Hospitals Treating Pulsus

Risk calculators and risk factors for Pulsus

Healthcare Provider Resources

Symptoms of Pulsus

Causes & Risk Factors for Pulsus

Diagnostic studies for Pulsus

Treatment of Pulsus

Continuing Medical Education (CME)

CME Programs on Pulsus

International

Pulsus en Espanol

Pulsus en Francais

Business

Pulsus in the Marketplace

Patents on Pulsus

Experimental / Informatics

List of terms related to Pulsus

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

There are four separate findings that pulsus may refer to:

## Contents

* 1 Pulsus tardus et parvus
* 2 Pulsus bisferiens
* 3 Pulsus bigeminus
* 4 Pulsus paradoxus
* 5 References

### Pulsus tardus et parvus

[edit | edit source]

Pulsus tardus et parvus also known as Pulsus parvus et tardus, more commonly known as a "slow-rising" or "anacrotic" pulse, is a sign where, upon palpation, the pulse is weak/small (parvus), and late (tardus) relative to contraction of the heart. Classically, it is seen in aortic valve stenosis.

With respect to aortic stenosis, "typical findings include a narrow pulse pressure, a harsh late-peaking systolic murmur heard best at the right second intercostal space with radiation to the carotid arteries, and a delayed slow-rising carotid upstroke (pulsus parvus et tardus)."[1]

### Pulsus bisferiens

[edit | edit source]

Pulsus bisferiens also bisferious pulse or biphasic pulse, is a sign where, on palpation of the pulse, a double peak per cardiac cycle can be appreciated. Bisferious means striking twice. Classically, it is detected when aortic insufficiency exists in association with aortic stenosis, but may also be found in isolated but severe aortic insufficiency, and hypertrophic obstructive cardiomyopathy.

### Pulsus bigeminus

[edit | edit source]

Pulsus bigeminus is a cardiovascular phenomenon characterized by groups of two heartbeats close together followed by a longer pause. The second pulse is weaker than the first. It is caused by premature contractions, usually of the ventricles, after every other beat. It can be a sign of hypertrophic obstructive cardiomyopathy or of many other types of heart disease. It can also be an innocent and passing phenomenon.

### Pulsus paradoxus

[edit | edit source]

Pulsus paradoxus (PP), also paradoxic pulse and paradoxical pulse, is an exaggeration of the normal variation in the pulse during the inspiratory phase of respiration, in which the pulse becomes weaker as one inhales and stronger as one exhales. It is a sign that is indicative of several conditions including cardiac tamponade and lung diseases (e.g. asthma, COPD).[1]

The paradox in pulsus paradoxus is that, on clinical examination, one can detect extra beats on cardiac auscultation, during inspiration, when compared to the radial pulse.[1] It results from an accentuated decrease of the blood pressure, which leads to the (radial) pulse not being palpable and may be accompanied by an increase in the jugular venous pressure height (Kussmaul sign). As is usual with inspiration, the heart rate is increased,[2] due to increased venous return.[3]

## References

[edit | edit source]

1. ↑ 1.0 1.1 Khasnis A, Lokhandwala Y. Clinical signs in medicine: pulsus paradoxus. J Postgrad Med. 2002 Jan-Mar;48(1):46-9. PMID 12082330. Free Full Text.
2. ↑ Guntheroth W, Morgan B, Mullins G (1967). "Effect of respiration on venous return and stroke volume in cardiac tamponade. Mechanism of pulsus parodoxus". Circ. Res. 20 (4): 381–90. PMID 6025402.CS1 maint: Multiple names: authors list (link)  Abstract
3. ↑ Soucek M, Kára T, Jurák P, Halámek J, Spinarová L, Meluzín J, Toman J, Rihácek I, Sumbera J, Frána P (2003). "Heart rate and increased intravascular volume". Physiological research / Academia Scientiarum Bohemoslovaca. 52 (1): 137–40. PMID 12625819.CS1 maint: Multiple names: authors list (link)  Free Full Text.

* v
* t
* e

Cardiovascular disease (heart)

Ischaemic|

| Coronary disease|

* Coronary artery disease (CAD)
* Coronary artery aneurysm
* Spontaneous coronary artery dissection (SCAD)
* Coronary thrombosis
* Coronary vasospasm
* Myocardial bridge

|

Active ischemia|

* Angina pectoris
* Prinzmetal's angina
* Stable angina
* Acute coronary syndrome
* Myocardial infarction
* Unstable angina

Sequelae|

* hours
* Hibernating myocardium
* Myocardial stunning
* days
* Myocardial rupture
* weeks
* Aneurysm of heart / Ventricular aneurysm
* Dressler syndrome

Layers|

| Pericardium|

* Pericarditis
* Acute
* Chronic / Constrictive
* Pericardial effusion
* Cardiac tamponade
* Hemopericardium

|

Myocardium|

* Myocarditis
* Chagas disease
* Cardiomyopathy
* Dilated
* Alcoholic
* Hypertrophic
* Tachycardia-induced
* Restrictive
* Loeffler endocarditis
* Cardiac amyloidosis
* Endocardial fibroelastosis
* Arrhythmogenic right ventricular dysplasia

Endocardium /
valves|

| Endocarditis|

* infective endocarditis
* Subacute bacterial endocarditis
* non-infective endocarditis
* Libman–Sacks endocarditis
* Nonbacterial thrombotic endocarditis

|

Valves|

* mitral
* regurgitation
* prolapse
* stenosis
* aortic
* stenosis
* insufficiency
* tricuspid
* stenosis
* insufficiency
* pulmonary
* stenosis
* insufficiency

Conduction /
arrhythmia|

| Bradycardia|

* Sinus bradycardia
* Sick sinus syndrome
* Heart block: Sinoatrial
* AV
* 1°
* 2°
* 3°
* Intraventricular
* Bundle branch block
* Right
* Left
* Left anterior fascicle
* Left posterior fascicle
* Bifascicular
* Trifascicular
* Adams–Stokes syndrome

|

Tachycardia
(paroxysmal and sinus)|

| Supraventricular|

* Atrial
* Multifocal
* Junctional
* AV nodal reentrant
* Junctional ectopic

|

Ventricular|

* Accelerated idioventricular rhythm
* Catecholaminergic polymorphic
* Torsades de pointes

Premature contraction|

* Atrial
* Junctional
* Ventricular

Pre-excitation syndrome|

* Lown–Ganong–Levine
* Wolff–Parkinson–White

Flutter / fibrillation|

* Atrial flutter
* Ventricular flutter
* Atrial fibrillation
* Familial
* Ventricular fibrillation

Pacemaker|

* Ectopic pacemaker / Ectopic beat
* Multifocal atrial tachycardia
* Pacemaker syndrome
* Parasystole
* Wandering atrial pacemaker

Long QT syndrome|

* Andersen–Tawil
* Jervell and Lange-Nielsen
* Romano–Ward

Cardiac arrest|

* Sudden cardiac death
* Asystole
* Pulseless electrical activity
* Sinoatrial arrest

Other / ungrouped|

* hexaxial reference system
* Right axis deviation
* Left axis deviation
* QT
* Short QT syndrome
* T
* T wave alternans
* ST
* Osborn wave
* ST elevation
* ST depression
* Strain pattern

Cardiomegaly|

* Ventricular hypertrophy
* Left
* Right / Cor pulmonale
* Atrial enlargement
* Left
* Right
* Athletic heart syndrome

Other|

* Cardiac fibrosis
* Heart failure
* Diastolic heart failure
* Cardiac asthma
* Rheumatic fever

Template:SIB

Template:WH Template:WS
*[v]: View this template
*[t]: Discuss this template
*[e]: Edit this template