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 radial arteries but character is better assessed in carotid artery. Pulsus bisferiens is best felt in brachial and femoral arteries. 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
Characteristic causes:
- Aortic regurgitation (AR)
- Aortic regurgitation with Aortic Stenosis (AR+AS)
- Hypertrophic cardiomyopathy[2]
References
Further reading
- harrisons book of medicine - 15th edition page 1255 and 1305.
- Fleming, PR (1 October 1957). "The mechanism of the pulsus bisferiens". Heart. 19 (4): 519–524. doi:10.1136/hrt.19.4.519. PMC 503962. PMID 13471818.
External links
- Bisferious pulse - Dorland's Medical Dictionary
- Bisferious - Dictionary.com
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