Carotid Artery Pulse (Fig. 110-1)

• Pulsus parvus: Weak upstroke due to decreased stroke volume (hypovolemia, LV failure, aortic or mitral stenosis [MS])
• Pulsus tardus: Delayed upstroke (aortic stenosis)
• Bounding (hyperkinetic) pulse: Hyperkinetic circulation, aortic regurgitation, patent ductus arteriosus, marked vasodilation
• Pulsus bisferiens: Double systolic pulsation (aortic regurgitation, hypertrophic cardiomyopathy)
• Pulsus alternans: Regular alteration in pulse pressure amplitude (severe LV dysfunction)
• Pulsus paradoxus: Exaggerated inspiratory fall (>10 mmHg) in systolic bp (pericardial tamponade, severe obstructive lung disease)