The Carotid Pulse I: Diagnosis of Aortic Stenosis by External Recordings

The brachial pulse is unreliable in the diagnosis of aortic stenosis as it may fail to show distinctive changes (Hancock and Abelmann, 1957; Hancock and Fleming, 1963). The carotid pulse should be more satisfactory for this purpose, since it reflects central events more clearly and external recordings reproduce the pressure pulse simply and adequately In 1956 Duchosal et al. reported the use of extemal carotid pulse recordings in the diagnosis of aortic stenosis. Daoud, Reppert, and Butterworth (1959) and Smith et al. (1959) also found the method valuable, but these investigators relied on clinical diagnosis in most of their patients, and each group used a different method to analyse the pulse. The present study is an attempt to define reliable diagnostic criteria, and patients with aortic stenosis have been included only when the diagnosis has been proved by left heart catheterization, operation, or necropsy. Their pulse tracings have been compared with those from healthy people and patients with a wide variety of cardiovascular disorders.