CHARACTER OF THE PULSE WAVE

Sunday, February 19, 2012

In aortic stenosis a notch may appear on the upstroke of the pulse tracing, and clinically the pulse wave is felt to be prolonged and of small amplitude (Plateau type.)

Accentuation of the dicrotic wave, sometimes so marked as to give the impression of a double pulse at the wrist, may be found in any condition associated with vasodilatation, e.g. high fever. Excessive arterial pulsation in the neck may be seen in aortic incompetence, coarctation of the aorta or sometimes from kinking of the carotid artery due to unfolding of an athermanous aorta. Examination of the jugular veins for the normal ‘a’ (atrial, presystolic) and ‘v’ (ventricular) waves may give useful information thus in tricuspid stenosis, pulmonary stenos is or pulmonary hypertension from any causes the ‘a’ wave will be exaggerated, and in functional or organic tricuspid incompetence a positive, systolic wave will replace the usual dip in pressure in early systole. The ‘c’ wave recorded by physiologists can rarely be seen