SherbyNet - /page/wikibook/entry.mu

Micron Document

<!DOCTYPE html>

<title>Pulse</title>

</head>

<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Pulse</span></span>

</h1>

</header>

/* start https://en.wikipedia.org/ */

.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><div role="note" class="hatnote navigation-not-searchable">This article is about heartbeats. For other uses, see <a href="Pulse_(disambiguation)" class="mw-disambig" title="Pulse (disambiguation)">Pulse (disambiguation)</a>.</div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}

/* end https://en.wikipedia.org/ */

</style>

/* start https://en.wikipedia.org/ */

.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}

/* end https://en.wikipedia.org/ */

</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: skyblue">Pulse</th></tr><tr><td colspan="2" class="infobox-image"><div class="infobox-caption">Diagram of the rise and fall of blood pressure from a pulse</div></td></tr><tr><th scope="row" class="infobox-label">Organisms</th><td class="infobox-data"><a href="Animalia" class="mw-redirect" title="Animalia">Animalia</a>*</td></tr><tr><th scope="row" class="infobox-label"><a href="Biological_system" title="Biological system">Biological system</a></th><td class="infobox-data"><a href="Circulatory_system" title="Circulatory system">Circulatory system</a></td></tr><tr><th scope="row" class="infobox-label">Action</th><td class="infobox-data">Involuntary</td></tr><tr><th scope="row" class="infobox-label">Method</th><td class="infobox-data">Heart pumps blood using <a href="Reciprocating_pump" title="Reciprocating pump">reciprocating method</a> causing inconstant blood flow throughout the circulatory system that can be recognized. (See <a href="Cardiac_cycle" title="Cardiac cycle">Cardiac cycle</a>)</td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">60–100 per minute (humans)</td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">0.6–1 second (humans)</td></tr><tr><td colspan="2" class="infobox-below">Animalia with the exception of <a href="Porifera" class="mw-redirect" title="Porifera">Porifera</a>, <a href="Cnidaria" title="Cnidaria">Cnidaria</a>, <a href="Ctenophora" title="Ctenophora">Ctenophora</a>, <a href="Platyhelminthes" class="mw-redirect" title="Platyhelminthes">Platyhelminthes</a>, <a href="Bryozoan" class="mw-redirect" title="Bryozoan">Bryozoan</a>, <a href="Amphioxus" class="mw-redirect" title="Amphioxus">Amphioxus</a></td></tr></tbody></table>

<p>In <a href="Medicine" title="Medicine">medicine</a>, <b>pulse</b> is the rhythmic expansion and contraction of an <a href="Artery" title="Artery">artery</a> in response to the <a href="Cardiac_cycle" title="Cardiac cycle">cardiac cycle</a> (heartbeat).<sup id="cite_ref-tfd_1-0" class="reference"><a href="#cite_note-tfd-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The pulse may be felt (<a href="Palpated" class="mw-redirect" title="Palpated">palpated</a>) in any place that allows an artery to be compressed near the surface of the body, such as at the <a href="Neck" title="Neck">neck</a> (<a href="Carotid_artery" title="Carotid artery">carotid artery</a>), <a href="Wrist" title="Wrist">wrist</a> (<a href="Radial_artery" title="Radial artery">radial artery</a> or <a href="Ulnar_artery" title="Ulnar artery">ulnar artery</a>), at the <a href="Groin" title="Groin">groin</a> (<a href="Femoral_artery" title="Femoral artery">femoral artery</a>), behind the <a href="Knee" title="Knee">knee</a> (<a href="Popliteal_artery" title="Popliteal artery">popliteal artery</a>), near the <a href="Ankle_joint" class="mw-redirect" title="Ankle joint">ankle joint</a> (<a href="Posterior_tibial_artery" title="Posterior tibial artery">posterior tibial artery</a>), and on foot (<a href="Dorsalis_pedis_artery" title="Dorsalis pedis artery">dorsalis pedis artery</a>).<sup id="cite_ref-Berg2006_2-0" class="reference"><a href="#cite_note-Berg2006-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-tfd_1-1" class="reference"><a href="#cite_note-tfd-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The pulse is most commonly measured at the wrist or neck for adults<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> and at the brachial artery (inner upper arm between the shoulder and elbow) for infants and very young children.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> A <a href="Sphygmograph" title="Sphygmograph">sphygmograph</a> is an instrument for measuring the pulse.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading2"><h2 id="Physiology">Physiology</h2></div>

<p>Claudius <a href="Galen" title="Galen">Galen</a> was perhaps the first <a href="Physiologist" class="mw-redirect" title="Physiologist">physiologist</a> to describe the pulse.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> The pulse is an expedient <a href="Touch" class="mw-redirect" title="Touch">tactile</a> method of determination of <a href="Systole_(medicine)" class="mw-redirect" title="Systole (medicine)">systolic</a> <a href="Blood_pressure" title="Blood pressure">blood pressure</a> to a trained observer. <a href="Diastolic" class="mw-redirect" title="Diastolic">Diastolic</a> blood pressure is non-palpable and unobservable by tactile methods, occurring between heartbeats.

</p><p><a href="Longitudinal_wave" title="Longitudinal wave">Pressure waves</a> generated by the heart in <a href="Systole_(medicine)" class="mw-redirect" title="Systole (medicine)">systole</a> move the arterial walls. Forward movement of <a href="Blood" title="Blood">blood</a> occurs when the boundaries are pliable and compliant. These properties form enough to create a palpable pressure wave.

</p><p>Pulse velocity, pulse deficits and much more physiologic data are readily and simplistically visualized by the use of one or more <a href="Arterial_catheter" class="mw-redirect" title="Arterial catheter">arterial catheters</a> connected to a <a href="Transducer" title="Transducer">transducer</a> and <a href="Oscilloscope" title="Oscilloscope">oscilloscope</a>. This invasive technique has been commonly used in <a href="Intensive_care" class="mw-redirect" title="Intensive care">intensive care</a> since the 1970s.

</p><p>The pulse may be further indirectly observed under light absorbances of varying wavelengths with assigned and inexpensively reproduced mathematical ratios. Applied capture of variances of light signal from the blood component <a href="Hemoglobin" title="Hemoglobin">hemoglobin</a> under oxygenated vs. deoxygenated conditions allows the technology of <a href="Pulse_oximetry" title="Pulse oximetry">pulse oximetry</a>.

</p>

<div class="mw-heading mw-heading2"><h2 id="Characteristics">Characteristics</h2></div>

<p></p><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="Heart_rate" title="Heart rate">Heart rate</a></div>

<p>The rate of the pulse can be observed and measured on the outside of an artery by tactile or visual means. It is recorded as arterial beats per minute or BPM. Although the pulse and heart beat are related, they are not the same. For example, there is a delay between the onset of the heart beat and the onset of the pulse, known as the <a href="Pulse_transit_time" class="mw-redirect" title="Pulse transit time">pulse transit time</a>, which varies by site. Similarly measurements of <a href="Heart_rate_variability" title="Heart rate variability">heart rate variability</a> and pulse rate variability differ.<sup id="cite_ref-Yuda2020_7-0" class="reference"><a href="#cite_note-Yuda2020-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup>

</p><p>In healthy people, the pulse rate is close to the <a href="Heart_rate" title="Heart rate">heart rate</a>, as measured by <a href="ECG" class="mw-redirect" title="ECG">ECG</a>.<sup id="cite_ref-Yuda2020_7-1" class="reference"><a href="#cite_note-Yuda2020-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> Measuring the pulse rate is therefore a convenient way to estimate the heart rate.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <b>Pulse deficit</b> is a condition in which a person has a difference between their pulse rate and heart rate. It can be observed by simultaneous <a href="Palpation" title="Palpation">palpation</a> at the <a href="Radial_artery" title="Radial artery">radial artery</a> and <a href="Auscultation" title="Auscultation">auscultation</a> using a <a href="Stethoscope" title="Stethoscope">stethoscope</a> <a href="Apex_beat" title="Apex beat">at the PMI, near the heart apex</a>, for example. Typically, in people with pulse deficit, heart beats do not result in pulsations at the periphery, meaning the pulse rate is lower than the heart rate. Pulse deficit has been found to be significant in the context of <a href="Premature_ventricular_contraction" title="Premature ventricular contraction">premature ventricular contraction</a> and <a href="Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Rhythm">Rhythm</h3></div>

<p>A normal pulse is regular in rhythm and force. An irregular pulse may be due to <a href="Sinus_arrhythmia" title="Sinus arrhythmia">sinus arrhythmia</a>, <a href="Ectopic_beats" class="mw-redirect" title="Ectopic beats">ectopic beats</a>, <a href="Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>, <a href="Paroxysmal_Atrial_Tachycardia" class="mw-redirect" title="Paroxysmal Atrial Tachycardia">paroxysmal atrial tachycardia</a>, <a href="Atrial_flutter" title="Atrial flutter">atrial flutter</a>, <a href="Second-degree_atrioventricular_block" title="Second-degree atrioventricular block">partial heart block</a> etc. Intermittent dropping out of beats at pulse is called "intermittent pulse". Examples of <i>regular</i> intermittent (regularly irregular) pulse include <a href="Pulsus_bigeminus" class="mw-redirect" title="Pulsus bigeminus">pulsus bigeminus</a>, <a href="Second-degree_atrioventricular_block" title="Second-degree atrioventricular block">second-degree atrioventricular block</a>. An example of <i>irregular</i> intermittent (irregularly irregular) pulse is <a href="Atrial_fibrillation" title="Atrial fibrillation">atrial fibrillation</a>.

</p>

<div class="mw-heading mw-heading3"><h3 id="Volume">Volume</h3></div>

<p>The degree of expansion displayed by artery during diastolic and systolic state is called volume. It is also known as amplitude, expansion or size of pulse.

</p>

<div class="mw-heading mw-heading4"><h4 id="Hypokinetic_pulse">Hypokinetic pulse</h4></div>

<p>A weak pulse signifies narrow <a href="Pulse_pressure" title="Pulse pressure">pulse pressure</a>. It may be due to low <a href="Cardiac_output" title="Cardiac output">cardiac output</a> (as seen in <a href="Shock_(circulatory)" title="Shock (circulatory)">shock</a>, <a href="Congestive_cardiac_failure" class="mw-redirect" title="Congestive cardiac failure">congestive cardiac failure</a>), <a href="Hypovolemia" title="Hypovolemia">hypovolemia</a>, <a href="Valvular_heart_disease" title="Valvular heart disease">valvular heart disease</a> (such as <a href="Aortic_stenosis" title="Aortic stenosis">aortic outflow tract obstruction</a>, <a href="Mitral_stenosis" title="Mitral stenosis">mitral stenosis</a>, <a href="Aortic_arch_syndrome" class="mw-redirect" title="Aortic arch syndrome">aortic arch syndrome</a>) etc.

</p>

<div class="mw-heading mw-heading4"><h4 id="Hyperkinetic_pulse">Hyperkinetic pulse</h4></div>

<p>A bounding pulse signifies high pulse pressure. It may be due to low <a href="Peripheral_resistance" class="mw-redirect" title="Peripheral resistance">peripheral resistance</a> (as seen in <a href="Fever" title="Fever">fever</a>, <a href="Anemia" title="Anemia">anemia</a>, <a href="Thyrotoxicosis" class="mw-redirect" title="Thyrotoxicosis">thyrotoxicosis</a>, hyperkinetic heart syndrome, <a href="Arteriovenous_fistula" title="Arteriovenous fistula">A-V fistula</a>, <a href="Paget's_disease_of_bone" title="Paget's disease of bone">Paget's disease</a>, <a href="Beriberi" class="mw-redirect" title="Beriberi">beriberi</a>, <a href="Liver_cirrhosis" class="mw-redirect" title="Liver cirrhosis">liver cirrhosis</a>), increased cardiac output, increased <a href="Stroke_volume" title="Stroke volume">stroke volume</a> (as seen in anxiety, exercise, <a href="Complete_heart_block" class="mw-redirect" title="Complete heart block">complete heart block</a>, <a href="Aortic_regurgitation" title="Aortic regurgitation">aortic regurgitation</a>), decreased distensibility of arterial system (as seen in <a href="Atherosclerosis" title="Atherosclerosis">atherosclerosis</a>, <a href="Hypertension" title="Hypertension">hypertension</a> and <a href="Coarctation_of_aorta" class="mw-redirect" title="Coarctation of aorta">coarctation of aorta</a>).

</p><p>The strength of the pulse can also be reported:<sup id="cite_ref-urlwww.meddean.luc.edu_10-0" class="reference"><a href="#cite_note-urlwww.meddean.luc.edu-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-urlVascular_Surgery,_University_of_Kansas_School_of_Medicine_11-0" class="reference"><a href="#cite_note-urlVascular_Surgery,_University_of_Kansas_School_of_Medicine-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup>

</p>

<ul><li>0 = Absent</li>

<li>1 = Barely palpable</li>

<li>2 = Easily palpable</li>

<li>4 = Aneurysmal or <a href="Bounding_pulse" class="mw-redirect" title="Bounding pulse">bounding pulse</a></li></ul>

<div class="mw-heading mw-heading3"><h3 id="Force">Force</h3></div>

<p>Also known as compressibility of pulse. It is a rough indication of <a href="Systolic_blood_pressure" class="mw-redirect" title="Systolic blood pressure">systolic blood pressure</a>.

</p>

<div class="mw-heading mw-heading3"><h3 id="Tension">Tension</h3></div>

<p>Determined mainly by mean arterial blood pressure; corresponds to <a href="Diastolic_blood_pressure" class="mw-redirect" title="Diastolic blood pressure">diastolic blood pressure</a>. A low tension pulse (pulsus mollis), the vessel is soft or impalpable between beats. In high tension pulse (pulsus durus), vessels feel rigid even between pulse beats.

</p>

<p>A form or contour of a pulse is palpatory estimation of <a href="Arteriogram" class="mw-redirect" title="Arteriogram">arteriogram</a>. A quickly rising and quickly falling pulse (pulsus celer) is seen in aortic regurgitation. A slow rising and slowly falling pulse (pulsus tardus) is seen in aortic stenosis.

</p>

<div class="mw-heading mw-heading3"><h3 id="Equality">Equality</h3></div>

<p>Comparing pulses and different places gives valuable clinical information.

</p><p>A discrepant or unequal pulse between left and right radial artery is observed in anomalous or aberrant course of artery, coarctation of aorta, <a href="Aortitis" title="Aortitis">aortitis</a>, <a href="Dissecting_aneurysm" class="mw-redirect" title="Dissecting aneurysm">dissecting aneurysm</a>, <a href="Peripheral_embolism" class="mw-redirect" title="Peripheral embolism">peripheral embolism</a> etc. An unequal pulse between upper and lower extremities is seen in coarctation to aorta, aortitis, block at <a href="Aortic_bifurcation" title="Aortic bifurcation">bifurcation of aorta</a>, <a href="Dissection_of_aorta" class="mw-redirect" title="Dissection of aorta">dissection of aorta</a>, <a href="Iatrogenic" class="mw-redirect" title="Iatrogenic">iatrogenic</a> trauma and <a href="Arteriosclerotic" class="mw-redirect" title="Arteriosclerotic">arteriosclerotic</a> obstruction.

</p>

<div class="mw-heading mw-heading3"><h3 id="Condition_of_arterial_wall">Condition of arterial wall</h3></div>

<p>A normal artery is not palpable after flattening by <a href="Finger" title="Finger">digital</a> pressure. A thick radial artery which is palpable 7.5–10 cm up the forearm is suggestive of arteriosclerosis.

</p>

<div class="mw-heading mw-heading3"><h3 id="Radio-femoral_delay">Radio-femoral delay</h3></div>

<p>In coarctation of aorta, femoral pulse may be significantly delayed as compared to radial pulse (unless there is coexisting aortic regurgitation). The delay can also be observed in <a href="Supravalvar_aortic_stenosis" class="mw-redirect" title="Supravalvar aortic stenosis">supravalvar aortic stenosis</a>.

</p>

<div class="mw-heading mw-heading2"><h2 id="Patterns">Patterns</h2></div>

<p>Several pulse patterns can be of clinical significance. These include:

</p>

<ul><li>Anacrotic pulse: notch on the upstroke of the carotid pulse. Two distinct waves (slow initial upstroke and delayed peak, which is close to S2). Present in AS.</li>

<li>Dicrotic pulse: is characterized by two beats per cardiac cycle, one systolic and the other diastolic. Physiologically, the dicrotic wave is the result of reflected waves from the lower extremities and aorta. Conditions associated with low cardiac output and high systemic vascular resistance can produce a dicrotic pulse.<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-McGee2016_13-0" class="reference"><a href="#cite_note-McGee2016-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup></li>

<li>Pulse deficit: difference in the heart rate by direct cardiac ausculation and by palpation of the peripheral arterial pulse rate when in atrial fibrillation (AF).</li>

<li><a href="Pulsus_alternans" title="Pulsus alternans">Pulsus alternans</a>: an ominous medical sign that indicates progressive systolic heart failure. To trained fingertips, the examiner notes a pattern of a strong pulse followed by a weak pulse over and over again. This pulse signals a flagging effort of the heart to sustain itself in systole. It also can be detected in HCM with obstruction.</li>

<li><a href="Pulsus_bigeminus" class="mw-redirect" title="Pulsus bigeminus">Pulsus bigeminus</a>: indicates a pair of hoofbeats within each heartbeat. Concurrent <a href="Auscultation" title="Auscultation">auscultation</a> of the heart may reveal a <a href="Gallop_rhythm" title="Gallop rhythm">gallop rhythm</a> of the native heartbeat.</li>

<li><a href="Pulsus_bisferiens" title="Pulsus bisferiens">Pulsus bisferiens</a>: is characterized by two beats per cardiac cycle, both systolic, unlike the dicrotic pulse. It is an unusual physical finding typically seen in patients with aortic valve diseases if the aortic valve does not normally open and close. Trained fingertips will observe two pulses to each heartbeat instead of one.</li>

<li><i>Pulsus tardus et parvus</i>, also <i>pulsus parvus et tardus</i>, slow-rising pulse and anacrotic pulse, is weak (parvus), and late (tardus) relative to its expected characteristics. It is caused by a stiffened aortic valve that makes it progressively harder to open, thus requiring increased generation of blood pressure in the left ventricle. It is seen in <a href="Aortic_valve_stenosis" class="mw-redirect" title="Aortic valve stenosis">aortic valve stenosis</a>.<sup id="cite_ref-McGee2016_13-1" class="reference"><a href="#cite_note-McGee2016-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid17384038_14-0" class="reference"><a href="#cite_note-pmid17384038-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-CFIM_15-0" class="reference"><a href="#cite_note-CFIM-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></li>

<li><a href="Pulsus_paradoxus" title="Pulsus paradoxus">Pulsus paradoxus</a>: a condition in which some heartbeats cannot be detected at the radial artery during the inspiration phase of respiration. It is caused by an exaggerated decrease in blood pressure during this phase, and is diagnostic of a variety of cardiac and respiratory conditions of varying urgency, such as <a href="Cardiac_tamponade" title="Cardiac tamponade">cardiac tamponade</a>.</li>

<li><a href="Tachycardia" title="Tachycardia">Tachycardia</a>: an elevated resting heart rate. In general an <a href="Electrocardiogram" class="mw-redirect" title="Electrocardiogram">electrocardiogram</a> (ECG) is required to identify the type of tachycardia.</li>

<li><a href="Pulsatile" class="mw-redirect" title="Pulsatile">Pulsatile</a> This description of the pulse implies the intrinsic physiology of <a href="Systole_(medicine)" class="mw-redirect" title="Systole (medicine)">systole</a> and <a href="Diastole" title="Diastole">diastole</a>. Scientifically, systole and diastole are <a href="Force" title="Force">forces</a> that expand and contract the pulmonary and systemic circulations.</li>

<li>A collapsing pulse is a sign of <a href="Hyperdynamic_circulation" title="Hyperdynamic circulation">hyperdynamic circulation</a>, which can be seen in AR or PDA.</li></ul>

<div class="mw-heading mw-heading2"><h2 id="Common_palpable_sites">Common palpable sites</h2></div>

<p>

</p><p>Sites can be divided into peripheral pulses and central pulses. Central pulses include the carotid and femoral pulses.<sup id="cite_ref-Berg2006_2-1" class="reference"><a href="#cite_note-Berg2006-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>

</p>

<div class="mw-heading mw-heading3"><h3 id="Upper_limb">Upper limb</h3></div>

<ul><li><b>Axillary pulse</b>: located inferiorly of the lateral wall of the <a href="Axilla" title="Axilla">axilla</a></li>

<li><b>Brachial pulse</b>: located on the inside of the upper arm near the elbow, frequently used in place of carotid pulse in infants (<a href="Brachial_artery" title="Brachial artery">brachial artery</a>)</li>

<li><b>Radial pulse</b>: located on the lateral of the wrist (<a href="Radial_artery" title="Radial artery">radial artery</a>). It can also be found in the <a href="Anatomical_snuff_box" class="mw-redirect" title="Anatomical snuff box">anatomical snuff box</a>. Commonly, the radial pulse is measured with three fingers. The finger closest to the heart is used to occlude the <a href="Pulse_pressure" title="Pulse pressure">pulse pressure</a>, the middle finger is used get a crude estimate of the <a href="Blood_pressure" title="Blood pressure">blood pressure</a>, and the finger most distal to the heart (usually the ring finger) is used to nullify the effect of the <a href="Ulnar_artery" title="Ulnar artery">ulnar pulse</a> as the two arteries are connected via the palmar arches (<a href="Superficial_palmar_arch" title="Superficial palmar arch">superficial</a> and <a href="Deep_palmar_arch" title="Deep palmar arch">deep</a>).</li>

<li><b>Ulnar pulse</b>: located on the medial of the wrist (<a href="Ulnar_artery" title="Ulnar artery">ulnar artery</a>).</li></ul>

<div class="mw-heading mw-heading3"><h3 id="Lower_limb">Lower limb</h3></div>

<ul><li><b><a href="Femoral_pulse" class="mw-redirect" title="Femoral pulse">Femoral pulse</a></b>: located in the inner thigh, at the <a href="Mid-inguinal_point" title="Mid-inguinal point">mid-inguinal point</a>, halfway between the pubic symphysis and anterior superior iliac spine (<a href="Femoral_artery" title="Femoral artery">femoral artery</a>).</li>

<li><b>Popliteal pulse</b>: Above the knee in the popliteal fossa, found by holding the bent knee. The patient bends the knee at approximately 124°, and the health care provider holds it in both hands to find the popliteal artery in the pit behind the knee (<a href="Popliteal_artery" title="Popliteal artery">popliteal artery</a>).</li>

<li><b>Dorsalis pedis pulse</b>: located on top of the foot, immediately lateral to the extensor of hallucis longus (<a href="Dorsalis_pedis_artery" title="Dorsalis pedis artery">dorsalis pedis artery</a>).</li>

<li><b>Tibialis posterior pulse</b>: located on the medial side of the ankle, 2 cm inferior and 2 cm posterior to the medial malleolus (<a href="Posterior_tibial_artery" title="Posterior tibial artery">posterior tibial artery</a>). It is easily palpable over <a href="Pimenta's_Point" class="mw-redirect" title="Pimenta's Point">Pimenta's Point</a>.</li></ul>

<ul><li><b><a href="Carotid_pulse" class="mw-redirect" title="Carotid pulse">Carotid pulse</a></b>: located in the neck (<a href="Carotid_artery" title="Carotid artery">carotid artery</a>). The carotid artery should be palpated gently and while the patient is sitting or lying down. Stimulating its baroreceptors with low palpitation can provoke severe <a href="Bradycardia" title="Bradycardia">bradycardia</a> or even stop the heart in some sensitive persons. Also, a person's two carotid arteries should not be palpated at the same time. Doing so may limit the flow of blood to the head, possibly leading to <a href="Fainting" class="mw-redirect" title="Fainting">fainting</a> or brain <a href="Ischemia" title="Ischemia">ischemia</a>. It can be felt between the anterior border of the sternocleidomastoid muscle, above the hyoid bone and lateral to the thyroid cartilage.</li>

<li><b>Facial pulse</b>: located on the mandible (lower jawbone) on a line with the corners of the mouth (<a href="Facial_artery" title="Facial artery">facial artery</a>).</li>

<li><b>Temporal pulse</b>: located on the <a href="Temple_(anatomy)" title="Temple (anatomy)">temple</a> directly in front of the ear (<a href="Superficial_temporal_artery" title="Superficial temporal artery">superficial temporal artery</a>).</li></ul>

<p>Although the pulse can be felt in multiple places in the head, people should not normally hear their heartbeats within the head. This is called <a href="Pulsatile_tinnitus" class="mw-redirect" title="Pulsatile tinnitus">pulsatile tinnitus</a>, and it can indicate several medical disorders.

</p>

<div class="mw-heading mw-heading3"><h3 id="Torso">Torso</h3></div>

<ul><li><b>Apical pulse</b>: located in the 5th left intercostal space, 1.25 cm lateral to the <a href="Mid-clavicular_line" class="mw-redirect" title="Mid-clavicular line">mid-clavicular line</a>. In contrast with other pulse sites, the apical pulse site is unilateral, and measured not under an artery, but below the <a href="Heart" title="Heart">heart</a> itself (more specifically, the apex of the heart). See also <a href="Apex_beat" title="Apex beat">apex beat</a>.</li></ul>

<div class="mw-heading mw-heading2"><h2 id="History">History</h2></div>

<p>Pulse rate was first measured by ancient Greek physicians and scientists. The first person to measure the heart beat was <a href="Herophilos" title="Herophilos">Herophilus of Alexandria</a>, <a href="Egypt" title="Egypt">Egypt</a> (c. 335–280 BC) who designed a water clock to time the pulse.<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> <a href="Rumi" title="Rumi">Rumi</a> has mentioned in a poem that "The wise physician measured the patient's pulse and became aware of his condition." It shows the practice was common during Rumi's era and geography.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup>

The first person to accurately measure the pulse rate was <a href="Santorio_Santorii" class="mw-redirect" title="Santorio Santorii">Santorio Santorii</a> who invented the <i>pulsilogium</i>, a form of <a href="Pendulum" title="Pendulum">pendulum</a> which was later studied by <a href="Galileo_Galilei" title="Galileo Galilei">Galileo Galilei</a>.<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> A century later another physician, <a href="Fran%C3%A7ois_Boissier_de_Sauvages_de_Lacroix" title="François Boissier de Sauvages de Lacroix">de Lacroix</a>, used the pulsilogium to test cardiac function.

</p>

<ul><li><a href="Pulse_meter" class="mw-redirect" title="Pulse meter">Pulse meter</a></li>

<li><a href="Tempo" title="Tempo">Tempo</a></li>

<li><a href="Pulse_diagnosis" title="Pulse diagnosis">Pulse diagnosis</a> – a practice in various types of traditional medicine</li>

<li><a href="Pulse_pressure" title="Pulse pressure">Pulse pressure</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .infobox .side-box{font-size:100%}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}

/* end https://en.wikipedia.org/ */

</style><style data-mw-deduplicate="TemplateStyles:r1237033735">

/* start https://en.wikipedia.org/ */

@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}

/* end https://en.wikipedia.org/ */

</style><div class="side-box side-box-right sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">

/* start https://en.wikipedia.org/ */

.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}

/* end https://en.wikipedia.org/ */

</style>

<div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Pulse" class="extiw external" title="commons:Category:Pulse">Pulse</a></span>.</div></div>

</div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}

/* end https://en.wikipedia.org/ */

</style><div class="reflist">

/* start https://en.wikipedia.org/ */

.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("./mw/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("./mw/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("./mw/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("./mw/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}

/* end https://en.wikipedia.org/ */

</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medical-dictionary.thefreedictionary.com/pulse">"pulse"</a>. <i>The Free Dictionary</i>.</cite></span>

</li>

<li id="cite_note-Berg2006-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Berg2006_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Berg2006_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFBergWorzala2006" class="citation book cs1">Berg, Dale; Worzala, Katherine (2006). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=B0MQhbQsd-IC&pg=PA80"><i>Atlas of Adult Physical Diagnosis</i></a>. Lippincott Williams & Wilkins. p. 80. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9780781741903</bdi>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230703125858/https://books.google.com/books?id=B0MQhbQsd-IC&pg=PA80">Archived</a> from the original on 2023-07-03<span class="reference-accessdate">. Retrieved <span class="nowrap">2020-10-03</span></span>.</cite></span>

</li>

<li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/003399.htm">"Pulse"</a>. <i>MedlinePlus Medical Encyclopedia</i><span class="reference-accessdate">. Retrieved <span class="nowrap">25 November</span> 2024</span>.</cite></span>

</li>

<li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><cite class="citation journal cs1"><span class="id-lock-subscription" title="Paid subscription required"><a rel="nofollow" class="external text" href="https://www.ahajournals.org/doi/10.1161/circ.102.suppl_1.I-253">"Part 9: Pediatric Basic Life Support"</a></span>. <i>Circulation</i>. <b>102</b> (suppl_1): I–253. 2000-08-22. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2Fcirc.102.suppl_1.I-253">10.1161/circ.102.suppl_1.I-253</a>.</cite></span>

</li>

<li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://medical-dictionary.thefreedictionary.com/sphygmograph">"sphygmograph"</a>. <i>The Free Dictionary</i>.</cite></span>

</li>

<li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text">Temkin 165;BBC[a]</span>

</li>

<li id="cite_note-Yuda2020-7"><span class="mw-cite-backlink">^ <a href="#cite_ref-Yuda2020_7-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Yuda2020_7-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFYudaYamamotoYoshidaHayano2020" class="citation journal cs1">Yuda, Emi; Yamamoto, Kento; Yoshida, Yutaka; Hayano, Junichiro (21 February 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035641">"Differences in pulse rate variability with measurement site"</a>. <i>Journal of Physiological Anthropology</i>. <b>39</b> (1): 4. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1186%2Fs40101-020-0214-1">10.1186/s40101-020-0214-1</a></span>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1880-6791">1880-6791</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035641">7035641</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32085811">32085811</a>.</cite></span>

</li>

<li id="cite_note-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-8">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.webmd.com/heart-disease/pulse-measurement">"Pulse Rate Measurement"</a>. <i>Healthwise</i>. WebMD. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20120723104209/http://www.webmd.com/heart-disease/pulse-measurement">Archived</a> from the original on 23 July 2012<span class="reference-accessdate">. Retrieved <span class="nowrap">14 March</span> 2011</span>.</cite></span>

</li>

<li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><cite id="CITEREFKaradavutAltintop2021" class="citation journal cs1">Karadavut, Serhat; Altintop, Ismail (30 November 2021). <a rel="nofollow" class="external text" href="https://doi.org/10.33963%2FKP.a2021.0107">"Pulse deficit in atrial fibrillation — a different perspective on rhythm or rate control strategy"</a>. <i>Kardiologia Polska</i>. <b>79</b> (11): <span class="nowrap">1231–</span>1238. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.33963%2FKP.a2021.0107">10.33963/KP.a2021.0107</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34506629">34506629</a>.</cite></span>

</li>

<li id="cite_note-urlwww.meddean.luc.edu-10"><span class="mw-cite-backlink"><b><a href="#cite_ref-urlwww.meddean.luc.edu_10-0">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.meddean.luc.edu/lumen/MedEd/Medicine/pulmonar/pd/step5b.htm">"www.meddean.luc.edu"</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20080907071727/http://www.meddean.luc.edu/lumen/meded/medicine/pulmonar/pd/step5b.htm">Archived</a> from the original on 2008-09-07<span class="reference-accessdate">. Retrieved <span class="nowrap">2009-05-20</span></span>.</cite></span>

</li>

<li id="cite_note-urlVascular_Surgery,_University_of_Kansas_School_of_Medicine-11"><span class="mw-cite-backlink"><b><a href="#cite_ref-urlVascular_Surgery,_University_of_Kansas_School_of_Medicine_11-0">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20090204080517/http://www.kumc.edu/vsurg/eval.htm">"Vascular Surgery, University of Kansas School of Medicine"</a>. Archived from <a rel="nofollow" class="external text" href="http://www.kumc.edu/vsurg/eval.htm">the original</a> on 2009-02-04<span class="reference-accessdate">. Retrieved <span class="nowrap">2009-05-20</span></span>.</cite></span>

</li>

<li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><cite id="CITEREFDennisBowenCho2016" class="citation book cs1">Dennis, Mark; Bowen, William Talbot; Cho, Lucy (2016). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=2lj_DAAAQBAJ&pg=PA177"><i>Mechanisms of Clinical Signs – EPub3</i></a>. Elsevier Health Sciences. p. 177. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9780729585613</bdi>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230703125812/https://books.google.com/books?id=2lj_DAAAQBAJ&pg=PA177">Archived</a> from the original on 2023-07-03<span class="reference-accessdate">. Retrieved <span class="nowrap">2018-01-02</span></span>.</cite></span>

</li>

<li id="cite_note-McGee2016-13"><span class="mw-cite-backlink">^ <a href="#cite_ref-McGee2016_13-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-McGee2016_13-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><cite id="CITEREFMcGee2016" class="citation book cs1">McGee, Steven (2016). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=k_sTDgAAQBAJ&pg=PA105"><i>Evidence-Based Physical Diagnosis E-Book</i></a>. Elsevier Health Sciences. pp. <span class="nowrap">105–</span>106. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9780323508711</bdi>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230703125814/https://books.google.com/books?id=k_sTDgAAQBAJ&pg=PA105">Archived</a> from the original on 2023-07-03<span class="reference-accessdate">. Retrieved <span class="nowrap">2018-01-02</span></span>.</cite></span>

</li>

<li id="cite_note-pmid17384038-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid17384038_14-0">^</a></b></span> <span class="reference-text"><cite id="CITEREFLiYuanQin2007" class="citation journal cs1">Li JC, Yuan Y, Qin W, et al. (April 2007). <a rel="nofollow" class="external text" href="http://www.jultrasoundmed.org/cgi/pmidlookup?view=long&pmid=17384038">"Evaluation of the tardus-parvus pattern in patients with atherosclerotic and nonatherosclerotic renal artery stenosis"</a>. <i>J Ultrasound Med</i>. <b>26</b> (4): <span class="nowrap">419–</span>26. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.7863%2Fjum.2007.26.4.419">10.7863/jum.2007.26.4.419</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17384038">17384038</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:11562194">11562194</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200510195342/https://onlinelibrary.wiley.com/journal/15509613?view=long&pmid=17384038">Archived</a> from the original on 2020-05-10<span class="reference-accessdate">. Retrieved <span class="nowrap">2018-01-02</span></span>.</cite></span>

</li>

<li id="cite_note-CFIM-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-CFIM_15-0">^</a></b></span> <span class="reference-text">Toy, Eugene, et al. <i>Case Files: Internal Medicine.</i> McGraw-Hill Companies, Inc. 2007. Page 43. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>0-07-146303-8</bdi>.</span>

</li>

<li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><cite id="CITEREFSandersWinter2007" class="citation book cs1">Sanders, Roger C.; Winter, Thomas Charles (2007). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=KUd6bLOtrxoC&pg=PA219"><i>Clinical Sonography: A Practical Guide</i></a>. Lippincott Williams & Wilkins. p. 219. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>9780781748698</bdi>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20230703125814/https://books.google.com/books?id=KUd6bLOtrxoC&pg=PA219">Archived</a> from the original on 2023-07-03<span class="reference-accessdate">. Retrieved <span class="nowrap">2018-01-02</span></span>.</cite></span>

</li>

<li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text"><cite id="CITEREFHajar2018" class="citation journal cs1">Hajar, R. (2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448473">"The Pulse from Ancient to Modern Medicine"</a>. <i>Heart Views</i>. <b>19</b> (3): <span class="nowrap">117–</span>120. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4103%2FHEARTVIEWS.HEARTVIEWS_16_19">10.4103/HEARTVIEWS.HEARTVIEWS_16_19</a></span>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448473">6448473</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31007864">31007864</a>.</cite></span>

</li>

<li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://ganjoor.net/moulavi/masnavi/daftar6/sh44">"Rumi poem on the afflicted patient"</a>. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20221216172056/https://ganjoor.net/moulavi/masnavi/daftar6/sh44">Archived</a> from the original on 2022-12-16<span class="reference-accessdate">. Retrieved <span class="nowrap">2022-12-16</span></span>.</cite></span>

</li>

<li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><cite id="CITEREFBigottiTaylor2017" class="citation journal cs1">Bigotti, Fabrizio; Taylor, David (2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407692">"The Pulsilogium of Santorio: New Light on Technology and Measurement in Early Modern Medicine"</a>. <i>Societate Si Politica</i>. <b>11</b> (2): <span class="nowrap">53–</span>113. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1843-1348">1843-1348</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407692">6407692</a></span>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30854144">30854144</a>.</cite></span>

</li>

</ol></div></div>

<div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2></div>

<ul><li><a rel="nofollow" class="external text" href="http://www.tapheartrate.com/">Measure Pulse Online</a> <i>Tap along with your pulse</i></li></ul>

/* start https://en.wikipedia.org/ */

.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}

/* end https://en.wikipedia.org/ */

</style><style data-mw-deduplicate="TemplateStyles:r1236075235">

/* start https://en.wikipedia.org/ */

.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output .navbox-list-with-group{text-align:left;border-left-width:2px;border-left-style:solid}.mw-parser-output tr+tr>.navbox-abovebelow,.mw-parser-output tr+tr>.navbox-group,.mw-parser-output tr+tr>.navbox-image,.mw-parser-output tr+tr>.navbox-list{border-top:2px solid #fdfdfd}.mw-parser-output .navbox-title{background-color:#ccf}.mw-parser-output .navbox-abovebelow,.mw-parser-output .navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}

/* end https://en.wikipedia.org/ */

</style></div><div role="navigation" class="navbox" aria-labelledby="Medical_examination_and_history_taking149" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><style data-mw-deduplicate="TemplateStyles:r1239400231">

/* start https://en.wikipedia.org/ */

.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><div id="Medical_examination_and_history_taking149" style="font-size:114%;margin:0 4em"><a href="Physical_examination" title="Physical examination">Medical examination</a> and <a href="Medical_history" title="Medical history">history taking</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Medical_history" title="Medical history">Medical history</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Chief_complaint" title="Chief complaint">Chief complaint</a></li>

<li><a href="History_of_the_present_illness" title="History of the present illness">History of the present illness</a></li>

<li><a href="Review_of_systems" title="Review of systems">Systems review</a></li>

<li><a href="Nursing_assessment" title="Nursing assessment">Nursing assessment</a></li>

<li><a href="Allergy" title="Allergy">Allergies</a>

<ul><li><a href="Medication" title="Medication">Medications</a></li></ul></li>

<li><a href="Past_medical_history" title="Past medical history">Past medical history</a></li>

<li><a href="Family_history_(medicine)" title="Family history (medicine)">Family history</a></li>

<li><a href="Social_history_(medicine)" title="Social history (medicine)">Social history</a></li>

<li><a href="Psychiatric_history" title="Psychiatric history">Psychiatric history</a></li>

<li><a href="Progress_note" title="Progress note">Progress notes</a></li>

<li>Mnemonics

<ul><li><a href="SAMPLE_history" title="SAMPLE history">SAMPLE</a></li>

<li><a href="OPQRST" title="OPQRST">OPQRST</a></li>

<li>COASTMAP</li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Physical_examination" title="Physical examination">Physical examination</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">General/<a href="IPPA" title="IPPA">IPPA</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Physical_examination" title="Physical examination">Inspection</a></li>

<li><a href="Auscultation" title="Auscultation">Auscultation</a></li>

<li><a href="Palpation" title="Palpation">Palpation</a></li>

<li><a href="Percussion_(medicine)" title="Percussion (medicine)">Percussion</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Vital_signs" title="Vital signs">Vital signs</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Thermoregulation" title="Thermoregulation">Temperature</a></li>

<li><a href="Heart_rate" title="Heart rate">Heart rate</a></li>

<li><a href="Blood_pressure" title="Blood pressure">Blood pressure</a></li>

<li><a href="Respiratory_rate" title="Respiratory rate">Respiratory rate</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="HEENT_examination" title="HEENT examination">HEENT</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Eye_examination" title="Eye examination">Eye examination</a>

<ul><li><a href="Ophthalmoscopy" title="Ophthalmoscopy">Ophthalmoscopy</a></li>

<li><a href="Swinging_light_test" title="Swinging light test">Swinging light test</a></li></ul></li>

<li><a href="Hearing_test" title="Hearing test">Hearing</a>

<ul><li><a href="Weber_test" title="Weber test">Weber</a></li>

<li><a href="Rinne_test" title="Rinne test">Rinne</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Respiratory_examination" title="Respiratory examination">Respiratory</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Respiratory_sounds" title="Respiratory sounds">Respiratory sounds</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cardiovascular_examination" title="Cardiovascular examination">Cardiovascular</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiac_examination" title="Cardiac examination">Cardiac examination</a></li>

<li><a href="Peripheral_vascular_examination" title="Peripheral vascular examination">Peripheral vascular examination</a></li>

<li><a href="Heart_sounds" title="Heart sounds">Heart sounds</a></li>

<li>Other

<ul><li><a href="Abdominojugular_test" title="Abdominojugular test">Abdominojugular test</a></li>

<li><a href="Ankle%E2%80%93brachial_pressure_index" title="Ankle–brachial pressure index">Ankle–brachial pressure index</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Abdominal_examination" title="Abdominal examination">Abdominal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Liver_span" title="Liver span">Liver span</a></li>

<li><a href="Rectal_examination" title="Rectal examination">Rectal examination</a></li>

<li><a href="Stomach_rumble" title="Stomach rumble">Bowel sounds</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Musculoskeletal</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Knee_examination" title="Knee examination">Knee examination</a></li>

<li><a href="Hip_examination" title="Hip examination">Hip examination</a></li>

<li><a href="Shoulder_examination" title="Shoulder examination">Shoulder examination</a></li>

<li><a href="Elbow" title="Elbow">Elbow examination</a></li>

<li><a href="GALS_screen" title="GALS screen">GALS screen</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Neurological_examination" title="Neurological examination">Neurological</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Mental_status_examination" title="Mental status examination">Mental status</a>

<ul><li><a href="Mini%E2%80%93mental_state_examination" title="Mini–mental state examination">Mini–mental state examination</a></li></ul></li>

<li><a href="Cranial_nerve_examination" title="Cranial nerve examination">Cranial nerve examination</a></li>

<li><a href="Upper_limb_neurological_examination" title="Upper limb neurological examination">Upper limb neurological examination</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Neonatal</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Apgar_score" title="Apgar score">Apgar score</a></li>

<li><a href="Ballard_Maturational_Assessment" title="Ballard Maturational Assessment">Ballard Maturational Assessment</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Pelvic_examination" title="Pelvic examination">Gynecological</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Well-woman_examination" title="Well-woman examination">Well-woman examination</a></li>

<li><a href="Breast_examination" title="Breast examination">Breast examination</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Preparticipation_physical_evaluation" title="Preparticipation physical evaluation">Sports</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Athletic_heart_syndrome" title="Athletic heart syndrome">Athletic heart syndrome</a></li>

<li><a href="Sudden_cardiac_death_of_athletes" title="Sudden cardiac death of athletes">Sudden cardiac death</a></li>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Assessment_and_plan" title="Assessment and plan">Assessment and plan</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Medical_diagnosis" title="Medical diagnosis">Medical diagnosis</a></li>

<li><a href="Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></li></ul>

</div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Physiology_of_the_cardiovascular_system139" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Physiology_of_the_cardiovascular_system139" style="font-size:114%;margin:0 4em"><a href="Cardiovascular_physiology" title="Cardiovascular physiology">Physiology of the cardiovascular system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Heart" title="Heart">Heart</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cardiac_output" title="Cardiac output">Cardiac output</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiac_cycle" title="Cardiac cycle">Cardiac cycle</a></li>

<li><a href="Cardiac_output" title="Cardiac output">Cardiac output</a>

<ul><li><a href="Heart_rate" title="Heart rate">Heart rate</a></li>

<li><a href="Stroke_volume" title="Stroke volume">Stroke volume</a></li></ul></li>

<li><a href="Stroke_volume" title="Stroke volume">Stroke volume</a>

<ul><li><a href="End-diastolic_volume" title="End-diastolic volume">End-diastolic volume</a></li>

<li><a href="End-systolic_volume" title="End-systolic volume">End-systolic volume</a></li></ul></li>

<li><a href="Afterload" title="Afterload">Afterload</a></li>

<li><a href="Preload_(cardiology)" title="Preload (cardiology)">Preload</a></li>

<li><a href="Frank%E2%80%93Starling_law" title="Frank–Starling law">Frank–Starling law</a></li>

<li><a href="Cardiac_function_curve" title="Cardiac function curve">Cardiac function curve</a></li>

<li><a href="Venous_return_curve" class="mw-redirect" title="Venous return curve">Venous return curve</a></li>

<li><a href="Wiggers_diagram" title="Wiggers diagram">Wiggers diagram</a></li>

<li><a href="Pressure%E2%80%93volume_diagram" title="Pressure–volume diagram">Pressure–volume diagram</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Echocardiography" title="Echocardiography">Ultrasound</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Ventricle_(heart)#Dimensions" title="Ventricle (heart)">Fractional shortening</a> = (<a href="End-diastolic_dimension" class="mw-redirect" title="End-diastolic dimension">End-diastolic dimension</a></li>

<li><a href="End-systolic_dimension" class="mw-redirect" title="End-systolic dimension">End-systolic dimension</a>) / End-diastolic dimension</li>

<li><a href="Aortic_valve_area_calculation" title="Aortic valve area calculation">Aortic valve area calculation</a></li>

<li><a href="Ejection_fraction" title="Ejection fraction">Ejection fraction</a></li>

<li><a href="Cardiac_index" title="Cardiac index">Cardiac index</a></li>

<li><a href="Left_atrial_volume" title="Left atrial volume">Left atrial volume</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Heart_rate" title="Heart rate">Heart rate</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiac_pacemaker" title="Cardiac pacemaker">Cardiac pacemaker</a></li>

<li><a href="Chronotropic" title="Chronotropic">Chronotropic</a> (<a href="Heart_rate" title="Heart rate">Heart rate</a>)</li>

<li><a href="Dromotropic" title="Dromotropic">Dromotropic</a> (<a href="Nerve_conduction_velocity" title="Nerve conduction velocity">Conduction velocity</a>)</li>

<li><a href="Inotrope" title="Inotrope">Inotropic</a> (Contractility)</li>

<li><a href="Bathmotropic" title="Bathmotropic">Bathmotropic</a> (Excitability)</li>

<li><a href="Lusitropy" title="Lusitropy">Lusitropic</a> (Relaxation)</li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Conduction</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiac_conduction_system" title="Cardiac conduction system">Conduction system</a></li>

<li><a href="Cardiac_electrophysiology" title="Cardiac electrophysiology">Cardiac electrophysiology</a></li>

<li>Action potential

<ul><li><a href="Cardiac_action_potential" title="Cardiac action potential">cardiac </a></li>

<li><a href="Atrial_action_potential" title="Atrial action potential">atrial</a></li>

<li><a href="Ventricular_action_potential" title="Ventricular action potential">ventricular</a></li></ul></li>

<li><a href="Effective_refractory_period" title="Effective refractory period">Effective refractory period</a></li>

<li><a href="Pacemaker_potential" title="Pacemaker potential">Pacemaker potential</a></li>

<li><a href="Electrocardiography" title="Electrocardiography">Electrocardiography</a>

<li><a href="PR_interval" title="PR interval">PR interval</a></li>

<li><a href="QRS_complex" title="QRS complex">QRS complex</a></li>

<li><a href="QT_interval" title="QT interval">QT interval</a></li>

<li><a href="ST_segment" title="ST segment">ST segment</a></li>

<li><a href="Hexaxial_reference_system" title="Hexaxial reference system">Hexaxial reference system</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Chamber pressure</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Central_venous_pressure" title="Central venous pressure">Central venous</a></li>

<li>Right

<ul><li><a href="Right_atrial_pressure" title="Right atrial pressure">atrial</a></li>

<li><a href="Right_ventricular_pressure" class="mw-redirect" title="Right ventricular pressure">ventricular</a></li></ul></li>

<li><a href="Pulmonary_artery_pressure" class="mw-redirect" title="Pulmonary artery pressure">pulmonary artery</a>

<ul><li><a href="Pulmonary_wedge_pressure" title="Pulmonary wedge pressure">wedge</a></li></ul></li>

<li>Left

<ul><li><a href="Pulmonary_wedge_pressure" title="Pulmonary wedge pressure">atrial</a></li>

<li><a href="Left_ventricular_pressure" class="mw-redirect" title="Left ventricular pressure">ventricular</a></li></ul></li>

<li><a href="Aortic_pressure" title="Aortic pressure">Aortic</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Ventricular_remodeling" title="Ventricular remodeling">Ventricular remodeling</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Circulatory_system" title="Circulatory system">Vascular system</a>/<br><a href="Hemodynamics" title="Hemodynamics">hemodynamics</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Hemodynamics" title="Hemodynamics">Blood flow</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Compliance_(physiology)" title="Compliance (physiology)">Compliance</a></li>

<li><a href="Vascular_resistance" title="Vascular resistance">Vascular resistance</a></li>

<li><a href="Perfusion" title="Perfusion">Perfusion</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Blood_pressure" title="Blood pressure">Blood pressure</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Pulse_pressure" title="Pulse pressure">Pulse pressure</a>

<ul><li><a href="Systole" title="Systole">Systolic</a></li>

<li><a href="Diastole" title="Diastole">Diastolic</a></li></ul></li>

<li><a href="Mean_arterial_pressure" title="Mean arterial pressure">Mean arterial pressure</a></li>

<li><a href="Jugular_venous_pressure" title="Jugular venous pressure">Jugular venous pressure</a></li>

<li><a href="Portal_venous_pressure" title="Portal venous pressure">Portal venous pressure</a></li>

<li><a href="Critical_closing_pressure" title="Critical closing pressure">Critical closing pressure</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cardiovascular_physiology#Regulation_of_blood_pressure" title="Cardiovascular physiology">Regulation of BP</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Baroreflex" title="Baroreflex">Baroreflex</a></li>

<li><a href="Kinin%E2%80%93kallikrein_system" title="Kinin–kallikrein system">Kinin–kallikrein system</a></li>

<li><a href="Renin%E2%80%93angiotensin_system" title="Renin–angiotensin system">Renin–angiotensin system</a></li>

<li><a href="Vasoconstriction" title="Vasoconstriction">Vasoconstrictors</a></li>

<li><a href="Vasodilation" title="Vasodilation">Vasodilators</a></li>

<li><a href="Autoregulation" title="Autoregulation">Autoregulation</a>

<ul><li><a href="Myogenic_mechanism" title="Myogenic mechanism">Myogenic mechanism</a></li>

<li><a href="Tubuloglomerular_feedback" title="Tubuloglomerular feedback">Tubuloglomerular feedback</a></li>

<li><a href="Cerebral_autoregulation" title="Cerebral autoregulation">Cerebral autoregulation</a></li></ul></li>

<li><a href="Paraganglion" title="Paraganglion">Paraganglia</a>

<ul><li><a href="Aortic_body" title="Aortic body">Aortic body</a></li>

<li><a href="Carotid_body" title="Carotid body">Carotid body</a></li>

<li><a href="Glomus_cell" title="Glomus cell">Glomus cell</a></li></ul></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

<div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Signs_and_symptoms_relating_to_the_circulatory_system180" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Signs_and_symptoms_relating_to_the_circulatory_system180" style="font-size:114%;margin:0 4em"><a href="Signs_and_symptoms" title="Signs and symptoms">Signs and symptoms</a> relating to the <a href="Circulatory_system" title="Circulatory system">circulatory system</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Chest_pain" title="Chest pain">Chest pain</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Referred_pain" title="Referred pain">Referred pain</a></li>

<li><a href="Angina" title="Angina">Angina</a>

<ul><li><a href="Levine's_sign" title="Levine's sign">Levine's sign</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Auscultation" title="Auscultation">Auscultation</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Heart_sounds" title="Heart sounds">Heart sounds</a>

<ul><li><a href="Split_S2" title="Split S2">Split S2</a></li>

<li><a href="Gallop_rhythm" title="Gallop rhythm">Gallop rhythm</a></li></ul></li>

<li><a href="Heart_murmur" title="Heart murmur">Heart murmur</a>

<ul><li><a href="Systolic_heart_murmur" title="Systolic heart murmur">Systolic</a>

<ul><li><a href="Functional_murmur" title="Functional murmur">Functional murmur</a></li>

<li><a href="Still's_murmur" title="Still's murmur">Still's murmur</a></li></ul></li>

<li><a href="Diastolic_heart_murmur" title="Diastolic heart murmur">Diastolic</a>

<ul><li><a href="Pulmonary_insufficiency" class="mw-redirect" title="Pulmonary insufficiency">Pulmonary insufficiency</a></li>

<li><a href="Graham_Steell_murmur" title="Graham Steell murmur">Graham Steell murmur</a></li></ul></li>

<li><a href="Continuous_murmurs" title="Continuous murmurs">Continuous</a></li>

<li><a href="Carey_Coombs_murmur" title="Carey Coombs murmur">Carey Coombs murmur</a></li>

<li><i><a href="Mitral_insufficiency" class="mw-redirect" title="Mitral insufficiency">Mitral insufficiency</a></i>

<ul><li><a href="Presystolic_murmur" title="Presystolic murmur">Presystolic murmur</a></li></ul></li></ul></li>

<li><a href="Pericardial_friction_rub" title="Pericardial friction rub">Pericardial friction rub</a></li>

<li><a href="Heart_click" title="Heart click">Heart click</a></li>

<li><a href="Bruit" title="Bruit">Bruit</a>

<ul><li><a href="Carotid_bruit" title="Carotid bruit">carotid</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Tachycardia" title="Tachycardia">Tachycardia</a></li>

<li><a href="Bradycardia" title="Bradycardia">Bradycardia</a></li>

<li><a href="Pulsus_paradoxus" title="Pulsus paradoxus">Pulsus paradoxus</a></li>

<li><i>doubled</i>

<ul><li><a href="Pulsus_bisferiens" title="Pulsus bisferiens">Pulsus bisferiens</a></li>

<li><a href="Pulsus_bigeminus" class="mw-redirect" title="Pulsus bigeminus">Pulsus bigeminus</a></li></ul></li>

<li><a href="Pulsus_alternans" title="Pulsus alternans">Pulsus alternans</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Palpitations" title="Palpitations">Palpitations</a>

<li><a href="C%C5%93ur_en_sabot" title="Cœur en sabot">Cœur en sabot</a></li>

<li><a href="Jugular_venous_pressure" title="Jugular venous pressure">Jugular venous pressure</a>

<ul><li><a href="Cannon_A_waves" title="Cannon A waves">Cannon A waves</a></li></ul></li>

<li><a href="Hyperaemia" title="Hyperaemia">Hyperaemia</a></li>

</ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Shock_(circulatory)" title="Shock (circulatory)">Shock</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Cardiogenic_shock" title="Cardiogenic shock">Cardiogenic</a></li>

<li><a href="Obstructive_shock" title="Obstructive shock">Obstructive</a></li>

<li><a href="Hypovolemia" title="Hypovolemia">Hypovolemic</a></li>

<li><a href="Distributive_shock" title="Distributive shock">Distributive</a></li>

<li>See further Template:Shock</li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Cardiovascular_disease" title="Cardiovascular disease">Cardiovascular disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Aortic_insufficiency" class="mw-redirect" title="Aortic insufficiency">Aortic insufficiency</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Collapsing_pulse" title="Collapsing pulse">Collapsing pulse</a></li>

<li><a href="De_Musset's_sign" title="De Musset's sign">De Musset's sign</a></li>

<li><a href="Duroziez's_sign" title="Duroziez's sign">Duroziez's sign</a></li>

<li><a href="M%C3%BCller's_sign" title="Müller's sign">Müller's sign</a></li>

<li><a href="Austin_Flint_murmur" title="Austin Flint murmur">Austin Flint murmur</a></li>

<li><a href="Mayne's_sign" title="Mayne's sign">Mayne's sign</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other <a href="Endocardium" title="Endocardium">endocardium</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i><a href="Endocarditis" title="Endocarditis">endocarditis</a>:</i> <a href="Roth's_spot" title="Roth's spot">Roth's spot</a></li>

<li><a href="Janeway_lesion" title="Janeway lesion">Janeway lesion</a>/<a href="Osler's_node" title="Osler's node">Osler's node</a></li>

<li><a href="Bracht%E2%80%93Wachter_bodies" title="Bracht–Wachter bodies">Bracht–Wachter bodies</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Pericardium" title="Pericardium">Pericardium</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i><a href="Cardiac_tamponade" title="Cardiac tamponade">Cardiac tamponade</a>/<a href="Pericardial_effusion" title="Pericardial effusion">Pericardial effusion</a>:</i> <a href="Beck's_triad_(cardiology)" title="Beck's triad (cardiology)">Beck's triad</a></li>

<li><a href="Ewart's_sign" title="Ewart's sign">Ewart's sign</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i><a href="Rheumatic_fever" title="Rheumatic fever">rheumatic fever</a>:</i></li>

<li><a href="Anitschkow_cell" title="Anitschkow cell">Anitschkow cell</a></li>

<li><a href="Aschoff_body" title="Aschoff body">Aschoff body</a></li>

<li><a href="Gallavardin_phenomenon" title="Gallavardin phenomenon">Gallavardin phenomenon</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Vascular_disease" title="Vascular disease">Vascular disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Artery" title="Artery">Arterial</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><i><a href="Aortic_aneurysm" title="Aortic aneurysm">aortic aneurysm</a></i>

<ul><li><a href="Cardarelli's_sign" title="Cardarelli's sign">Cardarelli's sign</a></li>

<li><a href="Oliver's_sign" title="Oliver's sign">Oliver's sign</a></li></ul></li>

<li><i><a href="Pulmonary_embolism" title="Pulmonary embolism">pulmonary embolism</a></i>

<ul><li><a href="Right_heart_strain" title="Right heart strain">Right heart strain</a></li></ul></li>

<li><i><a href="Radial_artery" title="Radial artery">radial artery sufficiency</a></i>

<ul><li><a href="Allen's_test" title="Allen's test">Allen's test</a></li></ul></li>

<li><i><a href="Pseudohypertension" title="Pseudohypertension">pseudohypertension</a></i></li>

<li><i><a href="Thrombus" title="Thrombus">thrombus</a></i>

<ul><li><a href="Lines_of_Zahn" title="Lines of Zahn">Lines of Zahn</a></li></ul></li>

<li><a href="Adson's_sign" title="Adson's sign">Adson's sign</a></li>

<li><i><a href="Arteriovenous_fistula" title="Arteriovenous fistula">arteriovenous fistula</a></i>

<ul><li><a href="Nicoladoni%E2%80%93Branham_sign" title="Nicoladoni–Branham sign">Nicoladoni–Branham sign</a></li></ul></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Vein" title="Vein">Venous</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Friedreich's_sign" title="Friedreich's sign">Friedreich's sign</a></li>

<li><a href="Caput_medusae" title="Caput medusae">Caput medusae</a></li>

<li><a href="Kussmaul's_sign" title="Kussmaul's sign">Kussmaul's sign</a></li>

<li><a href="Trendelenburg_test" title="Trendelenburg test">Trendelenburg test</a></li>

<li><i><a href="Superior_vena_cava_syndrome" title="Superior vena cava syndrome">superior vena cava syndrome</a></i>

<ul><li><a href="Pemberton's_sign" title="Pemberton's sign">Pemberton's sign</a></li></ul></li></ul>

</div></td></tr></tbody></table><div></div></td></tr></tbody></table></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}

/* end https://en.wikipedia.org/ */

</style></div><div role="navigation" class="navbox authority-control" aria-labelledby="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q191733#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1152" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><div id="Authority_control_databases_frameless&#124;text-top&#124;10px&#124;alt=Edit_this_at_Wikidata&#124;link=https&#58;//www.wikidata.org/wiki/Q191733#identifiers&#124;class=noprint&#124;Edit_this_at_Wikidata1152" style="font-size:114%;margin:0 4em">Authority control databases </div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">National</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://d-nb.info/gnd/4176336-1">Germany</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="Pulse"><a rel="nofollow" class="external text" href="https://id.loc.gov/authorities/sh85109028">United States</a></span></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="pulz (lékařství)"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&local_base=aut&ccl_term=ica=ph192846&CON_LNG=ENG">Czech Republic</a></span></span></li><li><span class="uid"><a rel="nofollow" class="external text" href="https://www.nli.org.il/en/authorities/987007548538605171">Israel</a></span></li></ul></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://lux.collections.yale.edu/view/concept/951d0e91-52e4-4a60-8be7-b8246b00b2e1">Yale LUX</a></span></li></ul></div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-07-15" href="https://en.wikipedia.org/wiki/?title=Pulse&oldid=1300592703">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

</div>

</div></div>

</div>

</main>

</div>

</body></html>