[L. pulsus, beating]
1. The 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.
3. 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.
A 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, 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.
In 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).
A palpable pulse felt between the xiphoid process and the navel. This is produced by the pulse of the abdominal aorta.
A pulse that varies from easily palpable to faintly palpable.
SYN: pulsus alternans
A pulse showing a secondary wave on the ascending limb of the main wave.
A pulse wave with two small notches on the ascending portion.
A 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.
SYN: apical impulse
Video for Pulse: Apical
asymmetrical radial pulse
SEE: Unequal pulse.
SEE: Resting pulse.
A pulse in which two regular beats are followed by a longer pause.
SYN: coupled pulse
A pulse marked by two systolic peaks on the pulse waveform. It is characteristic of aortic regurgitation (with or without aortic stenosis) and hypertrophic cardiomyopathy.
A pulse that reaches a higher intensity than normal, then disappears quickly.
SYN: collapsing pulse
A pulse felt in the brachial artery.
Video for Pulse: Brachial
Visible 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.
SYN: Quincke pulse
A pulse felt in the carotid artery.
Video for Pulse: Carotid
A pulse showing one or more secondary waves on the descending limb of the main wave.
A pulse wave with two small notches on the descending portion.
A pulse recorded near the origin of the carotid or subclavian arteries.
SEE: Bounding pulse.
SEE: waterhammer pulse
SEE: Bigeminal pulse.
A 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 pulse
A pulse felt over the dorsalis pedis artery of the foot.
Video for Pulse: Dorsalis Pedis
Intermittent subjective sensations of light that accompany the heartbeat.
A pulse felt over the femoral artery.
Video for Pulse: Femoral
SEE: Thready pulse.
A pulse due to expansion of veins of the liver at each ventricular contraction.
A pulse recorded in the proximal portions of the carotid, femoral, and brachial arteries.
A pulse in which occasional beats are skipped, caused by conditions such as premature atrial contractions, premature ventricular contractions, and atrial fibrillation.
SYN: irregular pulse
SEE: Intermittent pulse.
irregularly irregular pulse
The erratic, unpredictable pulse present in atrial fibrillation.
A venous pulse felt in the jugular vein.
SEE: Kussmaul, Adolph
A pulse in which the sphygmogram shows a simple ascending and descending uninterrupted line and no dicrotism.
A visible pulsation in the capillaries under the nails.
The oxygen consumption divided by the heart rate in beats per minute. It is an indirect measure of the cardiac stroke volume.
A 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.
SYN: Kussmaul pulse; pulsus paradoxus
A pulse recorded in the arteries (radial or pedal) in the distal portion of the limbs.
A pulse resulting from rapid distention and collapse of an artery as occurs in aortic regurgitation.
A pulse associated with an increase in pressure that slowly rises but is maintained.
A pulse felt over the popliteal artery.
Video for Pulse: Popliteal
SEE: capillary pulse
A pulse felt over the radial artery.
Video for Pulse: Radial
A 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).
Alternate dilatation and contraction of the large veins of the neck occurring simultaneously with inspiration and expiration.
A pulse rate obtained while an individual is at rest and calm.
SYN: basal pulse
A venous pulse felt over the suprasternal notch.
SEE: Riegel pulse
A weak, rapid pulse with one wave continuing into the next.
A pulse with a short, quick systolic wave.
A pulse rate that is less than 60 beats per minute.
A pulse that may be stopped by moderate digital compression.
A full but not bounding pulse.
A fine, scarcely perceptible pulse.
SYN: filiform pulse
A pulse in which a series of oscillations is felt with each beat.
A pulse with three separate expansions during each heartbeat.
A pulse with a longer or shorter interval after each three beats because the third beat is an extrasystole.
SEE: Waterhammer pulse.
A pulse that seems to have several successive waves.
A pulse in which beats vary in force.
SYN: asymmetrical radial pulse
A slow pulse resulting from parasympathetic influence on heart rate, mediated by the vagus nerve.
A 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.
A small, frequent pulse with a wormlike feeling.
A tense pulse that feels like a wire or firm cord.