Rubric PULSE is present in GENERALITIES chapter in both of these Repertories. In Boenninghausen’s Therapeutic Pocket Book rubric Pulse is coming under CIRCULATION chapter. [homeobook.com]

History Common clinical presentations are syncope, dyspnea, chest pain, and palpitations. Long-standing problems can remain asymptomatic and later can present with signs of acute pulmonary edema and heart failure. [ncbi.nlm.nih.gov]

• Asymptomatic

  Long-standing problems can remain asymptomatic and later can present with signs of acute pulmonary edema and heart failure. [ncbi.nlm.nih.gov]

• Weakness

  It is caused by premature contractions, usually of the ventricles, after every other… … Wikipedia Pulsus alternans — is a physical finding with arterial pulse waveform showing alternating strong and weak beats. [deacademic.com]

  The radial pulse may not correspond to the ventricular pulse (or apical pulse), as determined by auscultation of the heart tones or palpation of the cardiac impulse, because some ventricular contractions are too weak to propel blood to the radial artery [passeidireto.com]

  Pulsus alternans (during pulse palpation, this is the alternation of one strong and one weak beat without a change in the cycle length) occurs most commonly in heart failure due to increased resistance to LV ejection, as occurs in hypertension, aortic [medscape.com]

• Disability

  Life Threatening Causes Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. [wikidoc.org]

  RELAPSING PERICARDITIS Relapsing, idiopathic pericarditis is a condition in which the only disabling problem is the associated chest pain. It don not progress to constrictive pericarditis. It is only rarely ass ciated with aiThythmias. [archive.org]

• Collapse

  Collapsing or water hammer pulse with rapid upstroke & descent characteristically occurs n aortic regurgitation. Bisferiens pulse: this is a combination of low rising & collapsing pulses occurring when aortic stenosis & incompetence are present. [homeobook.com]

  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 [wikidoc.org]

• Fatigue

  […] consumption (so the patient has DOE and is easily fatigued). There are 2 general classifications of HF: Low- and High-output failure. [archive.org]

• Regurgitation

  This type of carotid pulse contour is most frequently observed in patients with hemodynamically significant aortic regurgitation or combined aortic stenosis and regurgitation with dominant regurgitation. [ourmedicine.blogspot.com]

  Assessment of valve morphology, determination of the aortic regurgitation jet, aortic regurgitation quantification, measurement of the aortic root and ascending aorta can be done with 2D-echocardiography. [ncbi.nlm.nih.gov]

• Diarrhea

  Major side effects of the A-ADs [Know]: la: Quinidine: Prolongs the QrL complex and the Q-T inter- val — occasionally leading to torsades de pointes, diarrhea, and (rarely) autoim mune thrombocytopenic purp ura. [archive.org]

• Heart Disease

  Heart. 2006 Jul;92(7):994-1000. [PMC free article: PMC1860728] [PubMed: 16775114] 7. Bekeredjian R, Grayburn PA. Valvular heart disease: aortic regurgitation. Circulation. 2005 Jul 05;112(1):125-34. [PubMed: 15998697] 8. [ncbi.nlm.nih.gov]

• Systolic Murmur

  Ejection systolic murmur in the aortic area (aortic stenosis), early diastolic murmur on the left sternum (aortic regurgitation), mid-diastolic or early diastolic low pitch rumble murmur at the apex (severe aortic regurgitation) which is also called as [ncbi.nlm.nih.gov]

• Austin Flint Murmur

  Austin Flint murmur, ejection systolic murmur along the left parasternal area (HOCM).[7] Aortic regurgitation can also present with other clinical signs such as blanching and flushing of the forehead and face (lighthouse sign), bobbing of the head synchronous [ncbi.nlm.nih.gov]

• Traube's Sign

  sign), a pistol shot sound both during systole and during diastole on auscultation (Traube sign), diastolic-systolic murmur over the femoral arteries (Duroziez murmur). [ncbi.nlm.nih.gov]

• Confusion

  Pulsus alternans From Wikipedia the free encyclopedia Jump to navigation search Not be confused with paradoxus [...] [i2mmarketing.com]

  Way back in 1952, it was described by Galen in De Pulsibus.[1] Pulsus bisferiens is associated with the severe aortic disease with aortic regurgitation and hypertrophic obstructive cardiomyopathy(HOCM).[2] Providers often confuse this with the dicrotic [ncbi.nlm.nih.gov]

• Seizure

  It also causes dr ug-induced lup us and must be used with caution in HF patients, because it has a mild myocardial depressive effect. lb: Lidocaine: Seizures. [archive.org]

As the authors are that suggesting OPAs might be used as a screening tool for other diseases, we would suggest thinking of “pulsus bisferiens” when noticing a waveform with two peaks, and direct a further workup toward aortic valve disease. [journals.lww.com]

On the other hand, it is beneficial in in the workup of those who present more than 24-48 hours after onset of symptoms. [archive.org]

• Left Atrial Hypertrophy

  ECG: Conduction abnormalities, atrial fibrillation (AF,) left ventricular hypertrophy, and left atrial hypertrophy are seen in both aortic valvular disease and HOCM. 2D-Echo: Echocardiography is the main diagnostic tool for diagnosing mixed aortic valve [ncbi.nlm.nih.gov]

The surgical treatment for HOCM is myomectomy, which improves the outcome. [ncbi.nlm.nih.gov]

It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. [deacademic.com]

Prognosis Mixed Aortic Valve Disease: Prognosis is generally good in patients with an isolated severe aortic regurgitation (AR) who are asymptomatic and have a preserved LV function. Patients with moderate to severe AR have a poor outcome. [ncbi.nlm.nih.gov]

Treatment / Management Management of pulsus bisferiens is based on its etiology. Early diagnosis and referral to cardiologists hold the key to success in the management, reducing mortality and morbidity. [ncbi.nlm.nih.gov]

[…] cardiomyopathy with obstruction (HOCM) Other causes are: Severe aortic regurgitation Large PDA (patent ductus arteriosus) or arteriovenous fistula Significant mitral valve prolapse Rarely seen in normal people with the hyperdynamic circulatory state Epidemiology [ncbi.nlm.nih.gov]

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. [wikidoc.org]

Pathophysiology In left ventricular dysfunction,… … Wikipedia pulsus paradoxus — pulsus par·a·dox·us .par ə däk səs n a pulse that weakens abnormally during inspiration and is symptomatic of various abnormalities (as pericarditis) * * * a large fall in [deacademic.com]

Objectives: Describe the pathophysiology of pulsus bisferiens. Outline the severity assessment of the cardiac conditions associated with pulsus bisferiens. [ncbi.nlm.nih.gov]

Genetic screening would help in the prevention, diagnosis, and management of patients with HOCM. [ncbi.nlm.nih.gov]