Pulsus
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There are four separate findings that pulsus may refer to:
Pulsus tardus et parvus
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
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
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
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,[1] due to increased venous return.[1]
References
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
