Physical Finding |
Associated cardiac condition(s) |
Pulse rate |
|
Heart rate < 60, >100 |
Sinus bradycardia, sinus tachycardia |
Irregularly irregular |
Atrial fibrillation |
Regularly irregular |
Bi-/trigeminy, 2nd degree atrioventricular block |
Pulse quality |
|
Radio-femoral delay |
Coarctation (associated with bicuspid aortic valve & aortic stenosis) |
Hypokinetic (low volume) |
Aortic stenosis, congestive heart failure, restrictive pericardial disease, mitral stenosis |
Hyperkinetic (large, bounding) |
Complete heart block, anxiety, anemia, exercise, fever, patent ductusarteriosus, peripheral atrioventricular fistula, mitral regurgitation, ventricular septal defect, aortic regurgitation |
Collapsing / Corrigan’s pulse (full hard pulse followed by a sudden collapse) |
Aortic regurgitation, hyperdynamic circulation, atherosclerotic aorta, patent ductusarteriosus, arteriovenous aneurysm |
Anacrotic (small volume, slow upstroke) |
Aortic stenosis |
Pulsusbisferiens (two systolic peaks) |
Aortic regurgitation, combined aortic regurgitation & aortic stenosis, hypertrophic cardiomyopathy, patent ductusarteriosus |
Dicrotic pulse |
Dilated cardiomyopathy |
Pulsusparvus (small weak pulse) |
Aortic stenosis |
Pulsustardus (delayed or slow rising systolic peak) |
Aortic stenosis |
Pulsusparvus et tardus (plateau pulse) |
Severe aortic stenosis |
Pulses paradoxus (a decrease in systolic blood pressure of >10 mm Hg during inspiration) |
Pulmonary embolism, superior vena cava obstruction, cardiac tamponade, constrictive pericarditis, airway obstruction, hypovolemia, pregnancy, morbid obesity |
Pulsusbigeminus (groups of two heartbeats close together followed by a longer pause; the second pulse is weaker than the first) |
Ventricular bigeminy, hypertrophic obstructive cardiomyopathy |
Pulsusalternans (alternating strong & weak pulses) |
Left ventricular failure (hypertension, aortic stenosis, coronary artery disease, dilated cardiomyopathies), during or post paroxysmal tachycardia |
Blood pressure |
|
120–139 or 80–89 mmHg |
Prehypertension |
< 140/90 mmHg |
Goal blood pressure in hypertensive patient |
< 130/80 mmHg |
Goal blood pressure in diabetes, chronic kidney disease, known coronary artery disease or equivalent (carotid artery disease, abdominal aortic aneurysm & peripheral vascular disease), or 10-year Framingham risk score of >=10%. |
< 120/80 mmHg |
Goal blood pressure in left ventricular dysfunction (ejection fraction <40%) |
Wide pulse pressure
(e.g. 180/80)
|
Aortic regurgitation |
Narrow pulse pressure (e.g. 120/100) |
Aortic stenosis |
Differential in 2 arms >10 mmHg |
Aortic dissection, aortic coarctation, arterial occlusion/stenosis of any cause |