Pulses

Key points

• Pulsus paradoxus: >10 mmHg inspiratory fall in systolic BP → faint/absent pulse in inspiration — severe asthma, cardiac tamponade.
• Slow-rising/plateau: aortic stenosis. Collapsing: AR · PDA · hyperkinetic states (anaemia, thyrotoxic, fever, pregnancy).
• Pulsus alternans: alternating pulse force — severe LVF.
• Bisferiens: two systolic peaks — mixed aortic valve disease. 'Jerky': HOCM.