Different Types of Abnormal Pulses Anacrotic Pulse Anacrotic pulse is a slow rising, twice beating pulse where both the waves are felt during systole. The waves that are felt are the anacrotic wave and the tidal wave. It is best felt in the carotids in aortic stenosis. Pulsus Bisferiens Pulsus bisferiens is a rapid rising, twice beating pulse where both the waves are felt during systole. Here the percussion wave is felt first followed by a small wave. It is seen in: Idiopathic hypertrophic subaortic stenosis – Here initially there is no obstruction to the outflow and about 80 percent of the stroke volume is ejected in the early part of systole. The obstruction occurs in midsystole when aortic valve approximates the hypertrophied septum. Hence, there is a dip, as suddenly the flow ceases, followed by a secondary rise as the L.V. overcomes the obstruction. Severe A.I. with mild A.S.: The volume flow is initially increased due to severe. A.I. mild A.S. causes a...
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