Pulsus tardus is due to delayed systolic peak in aortic valve stenosis. Large, bounding (hyperkinetic) pulse is usually associated with an increased left ventricular stroke volume, wide pulse pressure. Mitral regurgitation or a ventricular septal defect may also have a bounding pulse.
Pulsus tardus is due to delayed systolic peak in aortic valve stenosis. Large, bounding (hyperkinetic) pulse is usually associated with an increased left ventricular stroke volume, wide pulse pressure. Mitral regurgitation or a ventricular septal defect may also have a bounding pulse.
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Pulsus tardus is due to delayed systolic peak in aortic valve stenosis. Large, bounding (hyperkinetic) pulse is usually associated with an increased left ventricular stroke volume, wide pulse pressure. Mitral regurgitation or a ventricular septal defect may also have a bounding pulse.
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conditions with a diminished left ventricular stroke volume, a narrow pulse pressure, and increased peripheral vascular resistance. A hypokinetic pulse may be due to hypovolemia, to left ventricular failure, to restrictive pericardial disease, or to mitral valve stenosis. pulsus tardus, In aortic valve stenosis, the delayed systolic peak results from obstruction to left ventricular ejection. Large, bounding (hyperkinetic) pulse is usually associated with an increased left ventricular stroke volume, a wide pulse pressure, and a decrease in peripheral vascular resistance. This pattern occurs characteristically in patients with an elevated stroke volume, as in complete heart block; with hyperkinetic circulation due to anxiety, anemia, exercise, or fever; or with a rapid runoff of blood from the arterial system (as caused by a patent ductus arteriosus or peripheral arteriovenous fistula). Patients with mitral regurgitation or a ventricular septal defect may also have a bounding pulse, since vigorous left ventricular ejection produces a rapid upstroke in the arterial pulse, even though the duration of systole and the forward stroke volume may be reduced. In aortic regurgitation, the rapidly rising, bounding arterial pulse results from an increased left ventricular stroke volume and an increased rate of ventricular ejection. The bisferiens pulse, which has two systolic peaks, is characteristic of aortic regurgitation (with or without accompanying stenosis) and of hypertrophic cardiomyopathy. The dicrotic pulse has two palpable waves, one in systole and one in diastole. It usually denotes a very low stroke volume, particularly in patients with dilated cardiomyopathy. Pulsus alternans is a pattern in which there is regular alteration of the pressure pulse amplitude, despite a regular rhythm (Fig. 225-2). It is due to alternating left ventricular contractile force, usually indicates severe impairment of left ventricular function, and commonly occurs in patients who also have a loud third heart sound. Pulsus alternans may also occur during or following paroxysmal tachycardia or for several beats following a premature beat in patients without heart disease