Large, bounding arterial pulses usually indicate the rapid ejection of an increased volume of blood from the left ventricle (see Fig. 10-42^4). Commonly, the arterial pulse pressure is increased, and the peripheral arterial resistance diminished. The hyperdynamic arterial pulse is sometimes referred to in terms that describe a particular component of the pulse wave. Thus the water-hammer pulse, named after a Victorian toy, refers to an extremely rapid, forceful ascending limb of the arterial pulse wave.181 By contrast, collapsing pulse refers to a quick, marked decrease in the arterial pulse wave following its peak. Hyperkinetic pulses often are more prominent in the brachial, radial, and femoral arteries than in the carotid artery. The term Quincke pulse refers to visible small pulsations in the nail bed of patients with hyperdynamic arterial pulses from any cause, including aortic regurgitation.
Hyperkinetic arterial pulses occur in normal subjects with a hyperkinetic circulation (e.g., exercise, fever), patients with cardiovascular diseases associated with increased stroke volume, and subjects with marked bradycardia and an extremely large stroke volume (e.g., athletes). A hyperdynamic arterial pulse also occurs in patients with an abnormally rapid runoff of blood from the arterial system (e.g., patent ductus arteriosus, arteriovenous fistulas). Patients on chronic hemodialysis often have hyperdynamic pulses produced by the combination of a surgical arteriovenous fistula, anemia, and hypertension.
In aortic regurgitation, the rapid-rising, bounding arterial pulse results from increases in both stroke volume and the rate of LV ejection. The early systolic flow often produces palpable vibrations manifest as a thrill on the steep ascending limb. Later in systole, the rate of ventricular ejection and the arterial pulse wave decrease sharply, often resulting in systolic collapse.
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Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...