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DictionarySeewater-hammer pulseEncyclopediaSeepulsecollapsing pulse
wa·ter-·ham·mer pulsea pulse with forcible impulse but immediate collapse, characteristic of aortic incompetency.
See also: Corrigan sign. Synonym(s): cannonball pulse, collapsing pulse, piston pulse, pulsus celerrimus, triphammer pulseA booming, bounding, or pistol-shot-like sound heard by auscultation in aortic regurgitation or in a large patent ductus arteriosus—PDApulse (puls) [L. pulsus, beating] 1. Rate, rhythm, condition of arterial walls, compressibility and tension, and size and shape of the fluid wave of blood traveling through the arteries as a result of each heartbeat.2. Rhythmical throbbing. PULSES3. Throbbing caused by the regular contraction and alternate expansion of an artery as the wave of blood passes through the vessel; the periodic thrust felt over arteries in time with the heartbeat. See: illustrationA tracing of this is called a sphygmogram and consists of a series of waves in which the upstroke is called the anacrotic limb, and the downstroke (on which is normally seen the dicrotic notch), the catacrotic limb. The normal resting pulse in adults is between 60 and 100 beats per minute. The resting pulse is faster, for example, in febrile patients, anemic or hypovolemic persons, persons in shock, and patients who have taken drugs that stimulate the heart, such as theophylline, caffeine, nicotine, or cocaine. It may be slower in well-trained athletes; in patients using beta blockers, calcium channel blockers, or other agents; and during sleep or deep relaxation. Patient careIn patients complaining of chest pain, pulses should be assessed in at least two extremities (e.g., both radial arteries). A strong pulse on the right side with a weak one on the left may suggest an aortic dissection or a stenosis of the left subclavian artery. Young patients with high blood pressure should have pulses assessed simultaneously at the radial and femoral artery because a significant delay in the femoral pulse may suggest coarctation of the aorta. Patients with recent symptoms of stroke or claudication should have pulses checked at the carotid, radial, femoral, popliteal, and posterior tibial arteries, to see whether any palpable evidence of arterial insufficiency exists at any of these locations. If a decreased pulse is detected, further evaluation might include ultrasonography or assessments of the ankle brachial index. Patients who are lightheaded or dizzy or who notice palpitations may have detectable premature beats or other pulse irregularities (e.g., the irregularly irregular pulse of atrial fibrillation). abdominal pulseA palpable pulse felt between the xiphoid process and the navel. This is produced by the pulse of the abdominal aorta. alternating pulseA pulse with alternating weak and strong pulsations. Synonym: pulsus alternansanacrotic pulseA pulse showing a secondary wave on the ascending limb of the main wave.anadicrotic pulseA pulse wave with two small notches on the ascending portion.apical pulseA pulse felt or heard over the part of the chest wall that lies over the apex of the heart. In healthy people this is roughly located at the left mid-clavicular line in the fourth intercostal space. See: Pulse: Apicalasymmetrical radial pulseUnequal pulse.basal pulseResting pulse.bigeminal pulseA pulse in which two regular beats are followed by a longer pause. Synonym: coupled pulsebisferiens pulseA pulse marked by two systolic peaks on the pulse waveform. It is characteristic of aortic regurgitation (with or without aortic stenosis) and hypertrophic cardiomyopathy. bounding pulseA pulse that reaches a higher intensity than normal, then disappears quickly. Best detected when the arm is held aloft. Synonym: collapsing pulsebrachial pulseA pulse felt in the brachial artery. See: Pulse: Brachialcapillary pulseVisible inflow and outflow of blood from the nailbed. It is a finding in patients with aortic regurgitation when their fingernails or toenails are gently depressed by the examiner's finger. Synonym: Quincke's pulsecarotid pulseA pulse felt in the carotid artery. See: Pulse: Carotidcatacrotic pulseA pulse showing one or more secondary waves on the descending limb of the main wave.catadicrotic pulseA pulse wave with two small notches on the descending portion.central pulseA pulse recorded near the origin of the carotid or subclavian arteries.collapsing pulseBounding pulse.Corrigan's pulse See: waterhammer pulsecoupled pulseBigeminal pulse.dicrotic pulseA pulse with a double beat, one heartbeat for two arterial pulsations, or a seemingly weak wave between the usual heartbeats. This weak wave should not be counted as a regular beat. It is indicative of low arterial tension and is noted in fevers. dorsalis pedis pulseA pulse felt over the dorsalis pedis artery of the foot. See: Pulse: Dorsalis Pedisentoptic pulseIntermittent subjective sensations of light that accompany the heartbeat.femoral pulseA pulse felt over the femoral artery. See: Pulse: Femoralfiliform pulseThready pulse.hepatic pulseA pulse due to expansion of veins of the liver at each ventricular contraction.intermediate pulseA pulse recorded in the proximal portions of the carotid, femoral, and brachial arteries.intermittent pulseA pulse in which occasional beats are skipped, caused by conditions such as premature atrial contractions, premature ventricular contractions, and atrial fibrillation. Synonym: irregular pulseirregular pulseIntermittent pulse.irregularly irregular pulseThe erratic, unpredictable pulse present in atrial fibrillation.jugular pulseA venous pulse felt in the jugular vein.Kussmaul's pulse See: Kussmaul, Adolphmonocrotic pulseA pulse in which the sphygmogram shows a simple ascending and descending uninterrupted line and no dicrotism.nail pulseA visible pulsation in the capillaries under the nails.paradoxical pulseA decrease in the strength of the pulse (and of systolic blood pressure) during inspiration, a condition that may be esp. prominent in severe asthma, cardiac tamponade, obstructive sleep apnea, croup, and other conditions that alter pressure relationships within the chest. Synonym: Kussmaul's pulse; pulsus paradoxuspulse parvusPulsus parvus et tardus.peripheral pulseA pulse recorded in the arteries (radial or pedal) in the distal portion of the limbs.pistol-shot pulseA pulse resulting from rapid distention and collapse of an artery as occurs in aortic regurgitation.plateau pulseA pulse associated with an increase in pressure that slowly rises but is maintained.popliteal pulseA pulse felt over the popliteal artery. See: Pulse: PoplitealQuincke's pulse See: capillary pulseradial pulseA pulse felt over the radial artery. See: Pulse: Radialrapid pulseTachycardia.regular pulseA pulse felt when the force and frequency are the same (i.e., when the length of beat and number of beats per minute and the strength are the same).respiratory pulseAlternate dilatation and contraction of the large veins of the neck occurring simultaneously with inspiration and expiration.resting pulseA pulse rate obtained while an individual is at rest and calm. Synonym: basal pulseretrosternal pulseA venous pulse felt over the suprasternal notch.Riegel's pulse See: Riegel's pulserunning pulseA weak, rapid pulse with one wave continuing into the next.short pulseA pulse with a short, quick systolic wave.slow pulseA pulse rate that is less than 60 beats per minute.small pulse See: pulsus parvus et tardussoft pulseA pulse that may be stopped by moderate digital compression.tense pulseA full but not bounding pulse.thready pulseA fine, scarcely perceptible pulse. Synonym: filiform pulsetremulous pulseA pulse in which a series of oscillations is felt with each beat.tricrotic pulseA pulse with three separate expansions during each heartbeat.trigeminal pulseA pulse with a longer or shorter interval after each three beats because the third beat is an extrasystole.triphammer pulseWaterhammer pulse.undulating pulseA pulse that seems to have several successive waves.unequal pulseA pulse in which beats vary in force. Synonym: asymmetrical radial pulsevagus pulseA slow pulse resulting from parasympathetic influence on heart rate, mediated by the vagus nerve.venous pulseA pulse in a vein, esp. one of the large veins near the heart, such as the internal or external jugular. Normally it is undulating and scarcely palpable. In conditions such as tricuspid regurgitation, it is pronounced. vermicular pulseA small, frequent pulse with a wormlike feeling.waterhammer pulseA pulse with a powerful upstroke and then sudden disappearance; a hallmark of aortic regurgitation. Synonym: triphammer pulse; Corrigan's pulsewiry pulseA tense pulse that feels like a wire or firm cord.collapsing pulse A sharply rising and suddenly dropping pulse wave characteristic of leakage of the aortic valve of the heart (AORTIC INCOMPETENCE). |