Question
A 75-year-old woman with hypertension develops fatigue and dyspnea on exertion. Her blood pressure is 160/60 mm Hg and her pulse 80/min. The second heart sound is diminished and there is an early diastolic murmur that radiates from the right sternal border to the apex. Your clinical diagnosis is aortic regurgitation. select the characteristic arterial pulse finding.
| A. |
pulsus tardus
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| B. |
pulsus paradoxus
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| C. |
hyperkinetic pulse
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| D. |
bisferiens pulse
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Show Answer
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Correct Answer � C
Explanation
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Ans. (C)
A hyperkinetic pulse occurs in the setting of an elevated stroke volume (anemia, fever, anxiety) or an abnormally rapid runoff from the arterial system (aortic regurgitation, patent ductus arteriosus, arteriovenous fistula).
The hyperkinetic pulse is characterized by an increase in the velocity of the upstroke and amplitude.
Hyperkinetic pulses may be associated with anxiety, exercise, fever, thyrotoxicosis, hypertension, aortic regurgitation, arterio-venous fistula, and patent ductus arteriosus.
Patients with marked bradycardia may compensate with a large stroke volume clinically manifest by a hyperkinetic pulse.
The water-hammer, or Corrigan’s, pulse is characterized by a very brisk upstroke, large amplitude, and rapid collapse; it is an extreme form of the hyperkinetic pulse.
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