Tuesday, January 5, 2016

Q: "Pistol shot" pulsation is the hallmark of which disease?

Answer: Aortic Regurgitation

Wide pulse pressure in patients with Aortic Regurgitation gives some interesting findings which are also diagnostic of disease. 

A pistol shot pulse, also known as Traube's sign is an audible systolic and diastolic sounds heard over the femoral arteries. It is accompanied by a systolic and diastolic bruit audible when the femoral artery is partially compressed with stethoscope, known as Duroziez's sign. One famous and widely described clinical sign in this regard is Corrigan pulse, also known as 'water hammer or 'collapsing pulse', which is felt as a rapidly swelling and falling arterial pulse at radial, brachial or the carotid arteries. Also, capillary pulsations can be seen or feel at the fingertips or lips and known as Quincke's pulses. One dramatic and exotic physical finding is visible pulsations of the retinal arteries and pupils, known as Becker's sign. Also, pulsations can be felt at liver and spleen. Patient classically give description of "head bob occurring with each heart beat". 

On heart sounds, Austin flint murmur remained one widely described heart sound associated with aortic regurgitation.

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