Assessment of the arterial pulse characteristics is an integral part of the cardiovascular examination. Carotid, radial, brachial, femoral, posterior tibial, and dorsalis pedis pulses should be routinely examined bilaterally to ascertain any differences in the pulse amplitude, contour, or upstroke. Popliteal pulses should also be examined when lower extremity arterial disease is suspected.
The carotid pulse contour is very similar to that of the central aortic pulse; a delay in the onset of the ascending limb of the carotid pulse, compared with the central aortic pulse, is only about 20 msec. Thus, examination of the carotid pulse provides the most accurate representation of changes in the central aortic pulse. The brachial arterial pulse is examined to assess the volume and consistency of the peripheral vessels.
UNEQUAL OR DELAYED PULSES
Inequality in the amplitude of the peripheral pulses may result from:
●Obstructive arterial diseases, most commonly atherosclerosis