Q: What is "parvus and tardus" of carotid pulse in Αortic Stenosis?
Answer: "parvus and tardus" means low volume and slow rising
The carotid pulse in ΑS is usually low volume and slow rising. This can be appreciated by simultaneously listening to the point of maximum impulse at the heart apex. In a classic situation, "shuddering," i.e., carotid artery thrill or coarse vibration may also be present. Parvus and tardus are due to obstruction of flow at the aortic valve level, and shuddering is due to turbulence of blood flow across the stenotic valve.
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References:
1. Singh PK, Jangpangi G. Visible pulsus parvus et tardus in patient of aortic stenosis. BMJ Case Rep. 2017 Jul 5;2017:bcr2017221034. doi: 10.1136/bcr-2017-221034. PMID: 28679515; PMCID: PMC5535114.
2. Shivapour DM, Javed O, Wu Y, Brinza E, Hornacek D, Conic J, Gornik HL, Kim ESH. Changes in Carotid Duplex Ultrasound Velocities After Aortic Valve Replacement for Severe Aortic Stenosis. J Ultrasound Med. 2020 Jan;39(1):139-145. doi: 10.1002/jum.15087. Epub 2019 Jul 2. PMID: 31267549.
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