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An absent carotid pulse may indicate critical aortic stenosis

Anand Sachithanandan1, Pramod Bonde, Simon W MacGowan

  • 1Department of Cardiac Surgery, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6 BA, UK.

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

Severe aortic stenosis can cause weak or impalpable carotid pulses. Aortic valve replacement restored easily detectable pulses in a patient, highlighting this sign

Area of Science:

  • Cardiology
  • Vascular Medicine

Background:

  • Severe valvular aortic stenosis obstructs ventricular contraction, prolonging systole and reducing peak flow velocity.
  • This hemodynamic change can lead to diminished peripheral arterial pulses, including carotid pulses.

Purpose of the Study:

  • To report a case of severe aortic stenosis presenting with an impalpable carotid pulse.
  • To illustrate the impact of aortic valve replacement on peripheral pulse characteristics.

Main Methods:

  • Case report of a patient with severe aortic stenosis.
  • Clinical examination of peripheral pulses before and after aortic valve replacement.

Main Results:

  • The patient presented with an impalpable carotid pulse in the absence of local carotid artery disease.
  • Following aortic valve replacement, the carotid pulse became easily detectable.

Conclusions:

  • A weak or impalpable carotid pulse, in conjunction with an aortic stenosis murmur, is a significant indicator of critical aortic stenosis.
  • Urgent investigation is warranted in such cases.

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