Dicrotic pulse observed in a patient with prolapse of the aortic valve without aortic regurgitation

Area of Science:

• Cardiology
• Cardiovascular Physiology

Background:

• A dicrotic pulse, characterized by two distinct beats during each cardiac cycle, is uncommon.
• Its etiology is often associated with conditions affecting aortic valve function and systemic vascular resistance.

Observation:

• A case study involving a patient presenting with a dicrotic pulse.
• The patient exhibited a markedly prolapsed aortic cusp but no evidence of aortic regurgitation.
• Echocardiography-Doppler revealed deep retrograde flow in the abdominal aorta during early diastole.

Findings:

• The prolapsed aortic cusp, despite being non-leaking, was identified as the cause of the dicrotic pulse.
• The specific pattern of early diastolic reversal flow correlated with the observed dicrotic waveform.

Implications:

• This case highlights a novel mechanism for dicrotic pulse generation.
• It emphasizes the importance of considering aortic cusp morphology in the absence of regurgitation when diagnosing pulse abnormalities.
• Further research may elucidate the precise hemodynamic alterations leading to this phenomenon.