Editing Pulse (section)

==Patterns==
Several pulse patterns can be of clinical significance. These include:
* Anacrotic pulse: notch on the upstroke of the carotid pulse. Two distinct waves (slow initial upstroke and delayed peak, which is close to S2). Present in AS.
* Dicrotic pulse: is characterized by two beats per cardiac cycle, one systolic and the other diastolic.  Physiologically, the dicrotic wave is the result of reflected waves from the lower extremities and aorta. Conditions associated with low cardiac output and high systemic vascular resistance can produce a dicrotic pulse.<ref>{{cite book|last1=Dennis|first1=Mark|last2=Bowen|first2=William Talbot|last3=Cho|first3=Lucy|title=Mechanisms of Clinical Signs – EPub3|date=2016|publisher=Elsevier Health Sciences|isbn=9780729585613|page=177|url=https://books.google.com/books?id=2lj_DAAAQBAJ&pg=PA177|language=en|access-date=2018-01-02|archive-date=2023-07-03|archive-url=https://web.archive.org/web/20230703125812/https://books.google.com/books?id=2lj_DAAAQBAJ&pg=PA177|url-status=live}}</ref><ref name="McGee2016">{{cite book|last1=McGee|first1=Steven|title=Evidence-Based Physical Diagnosis E-Book|date=2016|publisher=Elsevier Health Sciences|isbn=9780323508711|pages=105–106|url=https://books.google.com/books?id=k_sTDgAAQBAJ&pg=PA105|language=en|access-date=2018-01-02|archive-date=2023-07-03|archive-url=https://web.archive.org/web/20230703125814/https://books.google.com/books?id=k_sTDgAAQBAJ&pg=PA105|url-status=live}}</ref>
* Pulse deficit: difference in the heart rate by direct cardiac ausculation and by palpation of the peripheral arterial pulse rate when in atrial fibrillation (AF).
* [[Pulsus alternans]]: an ominous medical sign that indicates progressive systolic heart failure. To trained fingertips, the examiner notes a pattern of a strong pulse followed by a weak pulse over and over again. This pulse signals a flagging effort of the heart to sustain itself in systole. It also can be detected in HCM with obstruction.
* [[Pulsus bigeminus]]: indicates a pair of hoofbeats within each heartbeat. Concurrent [[auscultation]] of the heart may reveal a [[gallop rhythm]] of the native heartbeat.
* [[Pulsus bisferiens]]: is characterized by two beats per cardiac cycle, both systolic, unlike the dicrotic pulse. It is an unusual physical finding typically seen in patients with aortic valve diseases if the aortic valve does not normally open and close. Trained fingertips will observe two pulses to each heartbeat instead of one.
* ''Pulsus tardus et parvus'', also ''pulsus parvus et tardus'', slow-rising pulse and anacrotic pulse, is weak (parvus), and late (tardus) relative to its expected characteristics. It is caused by a stiffened aortic valve that makes it progressively harder to open, thus requiring increased generation of blood pressure in the left ventricle.  It is seen in [[aortic valve stenosis]].<ref name=McGee2016/><ref name="pmid17384038">{{cite journal |vauthors=Li JC, Yuan Y, Qin W, etal |title=Evaluation of the tardus-parvus pattern in patients with atherosclerotic and nonatherosclerotic renal artery stenosis |journal=J Ultrasound Med |volume=26 |issue=4 |pages=419–26 |date=April 2007 |pmid=17384038 |doi=10.7863/jum.2007.26.4.419 |s2cid=11562194 |url=http://www.jultrasoundmed.org/cgi/pmidlookup?view=long&pmid=17384038 |doi-access=free |access-date=2018-01-02 |archive-date=2020-05-10 |archive-url=https://web.archive.org/web/20200510195342/https://onlinelibrary.wiley.com/journal/15509613?view=long&pmid=17384038 |url-status=live }}</ref><ref name="CFIM">Toy, Eugene, et al. ''Case Files: Internal Medicine.'' McGraw-Hill Companies, Inc. 2007. Page 43. {{ISBN|0-07-146303-8}}.</ref><ref>{{cite book|last1=Sanders|first1=Roger C.|last2=Winter|first2=Thomas Charles|title=Clinical Sonography: A Practical Guide|date=2007|publisher=Lippincott Williams & Wilkins|isbn=9780781748698|page=219|url=https://books.google.com/books?id=KUd6bLOtrxoC&pg=PA219|language=en|access-date=2018-01-02|archive-date=2023-07-03|archive-url=https://web.archive.org/web/20230703125814/https://books.google.com/books?id=KUd6bLOtrxoC&pg=PA219|url-status=live}}</ref>
* [[Pulsus paradoxus]]: a condition in which some heartbeats cannot be detected at the radial artery during the inspiration phase of respiration. It is caused by an exaggerated decrease in blood pressure during this phase, and is diagnostic of a variety of cardiac and respiratory conditions of varying urgency, such as [[cardiac tamponade]].
* [[Tachycardia]]: an elevated resting heart rate. In general an [[electrocardiogram]] (ECG) is required to identify the type of tachycardia.
* [[Pulsatile]] This description of the pulse implies the intrinsic physiology of [[Systole (medicine)|systole]] and [[diastole]]. Scientifically, systole and diastole are [[force]]s that expand and contract the pulmonary and systemic circulations.
*A collapsing pulse is a sign of [[hyperdynamic circulation]], which can be seen in AR or PDA.