Pulsus bisferiens: Difference between revisions

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Revision as of 16:02, 25 November 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Bisferious pulse, biphasic pulse, spike and dome pattern

Overview

Pulsus bisferiens is a sign where, on palpation of the pulse, a double peak in the aortic waveform is observed with each cardiac cycle.

Bisferious means striking twice. Therefore, pulsus bisferiens is a type of aortic waveform which has two systolic peaks separated by distinct mid-systolic dip

Pathophysiology

Hypertrophic Cardiomyopathy

Pulsus bisferiens is due to systolic anterior motion (SAM) of the mitral valve. Because the mitral valve leaflet doesn't get pulled into the left ventricular outflow tract (LVOT) until after the aortic valve opens, the initial upstroke of the arterial pulse pressure will be normal. When the mitral valve leaflet gets pushed into the LVOT, the arterial pulse will momentarily collapse and will later be followed by a second rise in the pulse pressure, as the left ventricular pressure overcomes the increased obstruction caused by the SAM of the mitral valve. This can be seen on the physical examination as a double tap upon palpation of the apical impulse and as a double pulsation upon palpation of the carotid pulse, known as pulsus bisferiensor a "spike and dome pattern" to the carotid pulse.

Causes Of Pulsus Bisferiens

  • It may also be found in:

Overview

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

The most common cause of --- is , other causes include:

Causes by Organ System

Cardiovascular
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug and Toxin Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic [No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying cause
Infectious Disease No underlying causes
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying cause
Nutritional / Metabolic No underlying cause
Obstetric/Gynecologic No underlying cause
Oncologic No underlying causes
Opthalmologic No underlying causes
Overdose / Toxicity [No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

Related chapters

References

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