Paradoxical, hyperdicrotic, and hemisystolic pulsation / by G. A. Gibson.

Date:
1903
Catalogue details

Licence: In copyright

Credit: Paradoxical, hyperdicrotic, and hemisystolic pulsation / by G. A. Gibson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    dicrotic pulse. In the second case (Fig. 2) the pulse is seen to he hyperdicrotic throughout, and the condition can hardly be said to be more fully marked during the inspiratory than during the Fig. 1.—Paradoxical pulse from a case of indurative mediastinal pericarditis, showing the respiratory curve as w'ell as the pulse. The rise in tlie rcspiratoiy curve is produced by inspiration. Ilypcrdicrotism is present in the liftli pulsation, corresponding to deep inspiration. expiratory phase. In the third instance (Fig. 3) the pulsation never becomes definitely hyperdicrotic, hut it is most interesting to notice that during inspiration it becomes fully dicrotic, which is not tlie case during the expiratory phase. On looking into the full details of this patient, it will he noticed that the paradoxical pulse is almost unilateral; while distinctly present in the right radial artery, it is scarcely perceptible in the left. Such a condition as this has been previously described by Mainzer,^ Gerhardt,^ and Harris.^ Fig. 2.—Paradoxical pulse from a case of pleurisy and pulmonary consolidation, with adhesive mediastinitis. The respiratory curve rises during inspii’ation. Hyperdicrotism is iiresent throughout. Now, when reviewing Mackenzie’s deeply interesting work on the pulse, in a recent number of this Journal,^ it seemed a duty to state my conviction that his explanation of hyperdicrotism,® as simply the result of acceleration of the heart, whereby the descending limb of the dicrotic notch is cut short, is not correct. The tracing above (No. 2) seems to bo sufficient to disprove the > Praff. Vrtljschr., 1879, Bd. i. S. 93. - Berl. Min. Wchnschr., 1897, Bd. xxxiv. S. 4 u. S. 285. ^ Lanccl, London, 1899, vol. i. ]i. 1072. * Edin. Med. Joitrn., N.S., 1903, vol. xiv. p. 59. “ “The Study of the Pulse,” Edin. and London, 1902, p. 26.