What is the term for this condition? - page 3

Can anyone help me out here? What's it called when a person has a different heart rate on one arm...i.e. one arm reads 44 and the other reads 88... Thanks :imbar... Read More

  1. by   suzanne4
    Differences in arms are perfusion problems, not conduction problems.
    Big difference...................

    I have worked on a heart team for years, and both ventricles pump together, not at different rates. Ask any cardiologist that...........

    Heart conduction doesn't change to each arm, perfusion does. Such as when a patient is having short runs of PVCs, those beats will not perfuse, so you will not be able to palpate them peripherally. With atril fib, you get poor perfusion.
    Last edit by suzanne4 on Jun 25, '04
  2. by   TechieNurse
    Palpitations...my best advice to you, go get checked out...EKG, Holter monitor, whatever...

    "both ventricles pump together, not at different rates. Ask any cardiologist that..."

    Suzanne4...just wondering about Torsades. Isn't that a condition where the ventricles don't work together? Could a self-limiting episode account for the differences in pulse & B/P? (not that I think Palpitations has this, I'm just wondering)
  3. by   Havin' A Party!
    Quote from RNKittyKat
    ... yes, peripheral pulses can be different...
    I agree.

    Just last night I checked a patient's pulse on the left radial and it was relatively strong and regular. Proceeded to the right and obtained a significantly lower rate (and weaker quality).

    Of course, there'e only one true heart rate (apical).
  4. by   wonderbee
    Quote from suzanne4
    Differences in arms are perfusion problems, not conduction problems.
    Big difference...................

    I have worked on a heart team for years, and both ventricles pump together, not at different rates. Ask any cardiologist that...........

    Heart conduction doesn't change to each arm, perfusion does. Such as when a patient is having short runs of PVCs, those beats will not perfuse, so you will not be able to palpate them peripherally. With atril fib, you get poor perfusion.
    Thanks Suzanne. This was a bee in my bonnet all night. I want to specialize in critical care so these issues send me running for the books. The patient who I took care of with the different peripheral pulses died of heart failure and was not perfusing well at all when I saw her as evidenced by cyanosis.
  5. by   Marie_LPN, RN
    Physical isn't really over. But so far i have:

    Pulsus differens, SVT, and "possible" HTN. Great. :stone
  6. by   Palpitations
    Quote from LPN2Be2004
    Physical isn't really over. But so far i have:

    Pulsus differens, SVT, and "possible" HTN. Great. :stone
    Did the doctor say how he/she is going to treat it?
  7. by   Palpitations
    I do have problems with low magnesium at times. Once my magnesium level was 1.2, and I was symptomatic. My symptoms were mainly cramping muscles and increased irritability. The doctor just told me to take oral magnesium for six days. My magnesium level went back up to 2.0. Later, it went back down to 1.8 (I was symptomatic then too.). They never did an EKG during these bouts.

    Weird huh?
  8. by   suzanne4
    Quote from LarryG
    I agree.

    Just last night I checked a patient's pulse on the left radial and it was relatively strong and regular. Proceeded to the right and obtained a significantly lower rate (and weaker quality).

    Of course, there'e only one true heart rate (apical).
    That is a perfusion problem, not conduction.
  9. by   gwenith
    As I said before - the most logical answer is a false reading from either different intensity of beat or an irregular beat that is read at the wrong time.

    Torsades is still a case of the ventricles beating "together" - the way they are wired makes beating together inevitable.
  10. by   suzanne4
    Quote from TechieNurse
    Palpitations...my best advice to you, go get checked out...EKG, Holter monitor, whatever...

    "both ventricles pump together, not at different rates. Ask any cardiologist that..."

    Suzanne4...just wondering about Torsades. Isn't that a condition where the ventricles don't work together? Could a self-limiting episode account for the differences in pulse & B/P? (not that I think Palpitations has this, I'm just wondering)
    Torsades is a prolonged QT interval. Ventricles will always work together.

    For more information on it, please check out this link:
    http://www.qtdrugs.org/info-center/torsades.htm
  11. by   leslie :-D
    to me this is quite black and white and what suzanne states makes perfect sense; bounding or weak/thready are two types of intensity which is irrelevent to the actual rate. just because a pulse's intensity might be so weak does not mean that the pulse wasn't there; it would reflect a vascular problem and not conduction. to get your actual pulse, then apical is the way to go. so no, you would not have 2 different pulse rates on your arms but could have 2 different intensities.
  12. by   Drysolong
    I thought the above was a strange response. As a student, this entire discussion has been very helpful to me
    Last edit by gwenith on Jun 26, '04 : Reason: quoting personal attack
  13. by   Indy
    Directed at MishlB:
    Cardiology is confusing to me, and I've encountered patients with apical/radial deficits before, as well as patients for whom the Dynamap (electronic vital signs machine thing) either won't work or gives really alarming readings. So far the discussion has been very helpful. If you have a problem with a well-educated nurse explaining pathophysiology in a manner that makes sense.

    -Indy
    Last edit by gwenith on Jun 26, '04 : Reason: personal attack

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