Pulsus bisferiens
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In medicine, pulsus bisferiens, also bisferious pulse or biphasic pulse, is a sign where, on palpation of the pulse, a double peak per cardiac cycle can be appreciated. Bisferious means striking twice. Classically, it is detected when aortic insufficiency exists in association with aortic stenosis,[1] but may also be found in isolated but severe aortic insufficiency, and hypertrophic obstructive cardiomyopathy.
Normally, arterial pulses are best felt in central arteries like the brachial and carotid arteries, but this is not the case for pulsus bisferiens. It is felt best in the radial artery. Another such pulse which can be felt better in peripheral arteries is pulsus alternans. The first lift is due to "percussion wave"(P) and the second lift is due to tidal wave (T).
- If P>T - AR>AS
- If T>P - AS>AR
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check harrisons book of medicine - 15 th edition page 1255 and 1305.
