Table 3: Palpation of extremities

Physical Finding Associated cardiac condition(s)
Pulse rate
Heart rate < 60, >100 Sinus bradycardia, sinus tachycardia
Irregularly irregular Atrial fibrillation
Regularly irregular Bi-/trigeminy, 2nd degree atrioventricular block
Pulse quality
Radio-femoral delay Coarctation (associated with bicuspid aortic valve & aortic stenosis)
Hypokinetic (low volume) Aortic stenosis, congestive heart failure, restrictive pericardial disease, mitral stenosis
Hyperkinetic (large, bounding) Complete heart block, anxiety, anemia, exercise, fever, patent ductusarteriosus, peripheral atrioventricular fistula, mitral regurgitation, ventricular septal defect, aortic regurgitation
Collapsing / Corrigan’s pulse (full hard pulse followed by a sudden collapse) Aortic regurgitation, hyperdynamic circulation, atherosclerotic aorta, patent ductusarteriosus, arteriovenous aneurysm
Anacrotic (small volume, slow upstroke) Aortic stenosis
Pulsusbisferiens (two systolic peaks) Aortic regurgitation, combined aortic regurgitation & aortic stenosis, hypertrophic cardiomyopathy, patent ductusarteriosus
Dicrotic pulse Dilated cardiomyopathy
Pulsusparvus (small weak pulse) Aortic stenosis
Pulsustardus (delayed or slow rising systolic peak) Aortic stenosis
Pulsusparvus et tardus (plateau pulse) Severe aortic stenosis
Pulses paradoxus (a decrease in systolic blood pressure of >10 mm Hg during inspiration) Pulmonary embolism, superior vena cava obstruction, cardiac tamponade, constrictive pericarditis, airway obstruction, hypovolemia, pregnancy, morbid obesity
Pulsusbigeminus (groups of two heartbeats close together followed by a longer pause; the second pulse is weaker than the first) Ventricular bigeminy, hypertrophic obstructive cardiomyopathy
Pulsusalternans (alternating strong & weak pulses) Left ventricular failure (hypertension, aortic stenosis, coronary artery disease, dilated cardiomyopathies), during or post paroxysmal tachycardia
Blood pressure
120–139 or 80–89 mmHg Prehypertension
< 140/90 mmHg Goal blood pressure in hypertensive patient
< 130/80 mmHg Goal blood pressure in diabetes, chronic kidney disease, known coronary artery disease or equivalent (carotid artery disease, abdominal aortic aneurysm & peripheral vascular disease), or 10-year Framingham risk score of >=10%.
< 120/80 mmHg Goal blood pressure in left ventricular dysfunction (ejection fraction <40%)
Wide pulse pressure (e.g. 180/80) Aortic regurgitation
Narrow pulse pressure (e.g. 120/100) Aortic stenosis
Differential in 2 arms >10 mmHg Aortic dissection, aortic coarctation, arterial occlusion/stenosis of any cause