Pulsus bisferiens
Medical problem affecting the aorta
Pulsus bisferiens, also known as biphasic pulse, is an aortic waveform with two peaks per cardiac cycle, a small one followed by a strong and broad one. It is a sign of problems with the aorta, including aortic stenosis and aortic regurgitation, as well as hypertrophic cardiomyopathy causing subaortic stenosis.
Pathogenesis
In hypertrophic cardiomyopathy, there is narrowing of the left ventricular outflow tract (LVOT) due to hypertrophy of the interventricular septum. During systole, the narrowing of the LVOT creates a more negative pressure due to the Venturi effect and sucks in the anterior mitral valve leaflet. This creates a transient occlusion of the LVOT, causing a midsystolic dip in the aortic waveform. Towards the end of systole, the ventricle is able to overcome the obstruction to cause the second rise in the aortic waveform.
In severe aortic regurgitation, additional blood reenters the left ventricle during diastole. This added volume of blood must be pumped out during ventricular systole. The rapid flow of blood during systole is thought to draw the walls of the aorta together due to the Venturi effect, temporarily decreasing blood flow during midsystole.
A recent paper theorized that an alternative explanation for pulsus bisferiens may be due to a forward moving suction wave occurring during mid-systole.
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The citation trail is more important than the brevity of the summary: it shows where individual claims can be examined in context. The source revision retrieved here is dated Nov 5, 2023. The linked authority identifier is Q7259713. None of the 0 selected statements returned an explicit reference.
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This entry incorporates text from “Pulsus bisferiens” on English Wikipedia. Contributors are listed in the page history. Text is available under the Creative Commons Attribution-ShareAlike 4.0 License. Selected authority identifiers and statements are retrieved from Wikidata under CC0; their references and qualifiers remain part of the verification path.