Usefulness of clinical assessment of the carotid pulse in the diagnosis of aortic stenosis

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Abstract

In a prospective controlled study, we compared the blinded assessment of the carotid pulse (independent of other clinical signs) by 1 of 3 cardiologists with applanation tonometry on the radial and carotid pulse (time to dominant peak and maximum rate of rise [−dP/dt]). We studied 23 patients with significant isolated aortic stenosis (AS) and 23 control patients. The odds ratio of finding a slowly rising pulse, representing AS, compared with a finding of a “normal”/“indeterminate” pulse was 10.4. Radial dP/dt was significantly lower in the group with AS, whereas carotid dP/dt was not significantly different between the 2 groups.

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Acknowledgements

We are indebted to Danni Molloy, BSc, for help with acquisition and analysis of data and the preparation of figures, Adrian Estermann, PhD, for help with the statistical analysis, and Marcus Ilton, MD, for help with clinical assessment of patients.

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