What is the term for this condition? - page 6

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   rn4booboo
    Quote from sagarcia210
    While a person has only one heart rate, the pulse CAN be different in the 2 arms. A higher pulse on the right radial with a low pulse on the left radial can be indicative of an aortic dissection or a stenosis of the left subclavian artery. It can also happen in atrial fibrillation.
    It is called PULSUS DIFFERENS.
    When I read this thread I knew the name, Thank you because it fell out of my head like a rock. Co arcs and tof's will cause the same thing also. Had a kid with a coarc before and totally different.
    Yes- we only have one heart- but many pathways and obstacles before the most popular pulse points.
    When in doubt take the apical, but WHY the diff in pulses is a big question not to just skip.
  2. by   leslie :-D
    the pulses are different in intensity only. but whatever the etiology, it needs follow up.
  3. by   Havin' A Party!
    Quote from Palpitations
    ... The stress from waiting could make me stroke out! :angryfire...
    Okay Palps, simma dawn na!!!

    Keep us posted after the appointment on the 18th.

    Good luck!
  4. by   kiddonurse
    [QUOTE=Palpitations]Update: I'm going in tomorrow to get the Holter monitor.

    I'll let you know what the results are.

    ~~~~~~~~~

    I was intrigued by this thread, because I also have had PSVT ... for at least 14 yrs. The first time I became aware of it was during my first pregnancy, and I had episodes with each pregnancy. (It was my "first sign" of being pregnant with my 4th child!) The first time it happened, I was around several nurses, and one took my apical pulse (couldn't palpate a radial) and couldn't count it ... estimated "over 200/min."

    I went to a cardiologist, wore a Holter, ... not one single episode, of course. The suggestion was that I was under stress. Not to worry. 2nd pregnancy, new state, new cardiologist, more understanding, but also "stress, avoid precipatating factors" (pregnancy? bending over? ... because that always was a trigger). It wasn't till my 4th pregnancy, when I was working PICU, and a coworker hooked me to a monitor ... we ran a strip of 257/min, I went to ER, ... lo and behold, "proof" is what counts. In retrospect, probably anyone could have diagnosed PSVT by the symptoms I was reporting, but it's easier to assume a woman can't have a cardiac situation, so it "must" be psychological.

    The cardiologist I now see, who specializes in rhythm disturbances, is completely patient, and values my decisions (like using Dig and holding off on that procedure ... ablation therapy ... where they can render inactive that part of your heart muscle that's responsible for the abnormal rhythm). It's so nice not to have people act like you are being silly, ... or worse.

    My advice: Don't be talked out of what you know you are experiencing. I KNOW, it's easy to be back down because you worry about being a hypochondriac, but you'd be upset if a pt let concerns about what a doc "thinks" about her stand in the way of her getting treatment. You deserve the same. Probably it's something as "minor" as SVT ... but it's always better to know than not know. You may not get a definitive dx if there are no SVT runs observed, but you will at least know from your workup that it isn't anything else.

    BTW, a coworker also was diagnosed while pregnant, and used Dig during the pregnancy, but then got the ablation treatment immediately after delivery, and recovered with no problems ... it's a valid tx option.
  5. by   kiddonurse
    Quote from Palpitations
    Well the preliminary report is: Lowest heart rate - 64; Highest heart rate - 141; and mean - 90; and one pvc. No SVT. They have to let a cardiologist read it to let me know anything more.

    It didn't help that I didn't have any real bouts of palpitations while wearing the Holter monitor. I was told that it could take the cardiologist up to a week to read the report.
    ~~~~~~~~~
    Palp: Here's a point: SVT is often called PSVT ... the paroxysmal means something like "coming and going." I think in some cases it's pretty typical NOT to be able to "catch" a run of SVT on any particular day that they decide to put you on a Holter monitor. Doesn't mean you don't have it, though. Hang in there, and at least be glad for the bigger work-up.
  6. by   Palpitations
    Quote from kiddonurse
    ~~~~~~~~~
    Palp: Here's a point: SVT is often called PSVT ... the paroxysmal means something like "coming and going." I think in some cases it's pretty typical NOT to be able to "catch" a run of SVT on any particular day that they decide to put you on a Holter monitor. Doesn't mean you don't have it, though. Hang in there, and at least be glad for the bigger work-up.
    Thanks for the information Kiddonurse. I know that I have some serious heart palpitations that awake me from my sleep and sometimes I get pressure in my chest. I just want to know if it is mental or physical. Whichever it is, it has got to be treated. I don't know which dx would be worse! Tsk! Tsk! The doctor that is supposed to be reading the strip is an electrophysiologist. Hopefully, he'll figure it out.

    Thanks again!
  7. by   efy2178
    Are you kidding? Right ventricle pumps blood to the lungs. Left ventricle pumps blood to the rest of the body. If you get one reading on one arm then another on the opposite arm then the heart rate is changing or you are misinterpreting the patient's pulse with your own. Is the heart rate regular? Are they on a monitor? Are they changing position when you take the pulses?


    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[/QUOTE]
  8. by   efy2178
    There are several kinds of SVT. Some have pathways which one is born with. AVNRT or AV Nodal Reentrant Tachycardia is an extra pathway which is characterised by a sudden increase in heart rate (150-200) usually initiated by a pre atrial contraction. Often times a person has to go to the ER and get converted with adenosine or verapamil. You do not want a tachycardia to last that long. It can take as little as a couple of weeks of a fast tachycardia (constant) to cause a cardiomyopathy. AVNRT is CURABLE with an AVNRT ablation (ablate the fast pathway). IF any of you think you have AVNRT get the tachycardia on an EKG. Text book says you probably had episodes since puberty or any time in your 20's (usually). Take the EKG (while in the tachycardia) to an electrophysiologist. He/she will be able to treat this.
    Lesson of the day.
  9. by   Palpitations
    [QUOTE=efy2178]Are you kidding? Right ventricle pumps blood to the lungs. Left ventricle pumps blood to the rest of the body. If you get one reading on one arm then another on the opposite arm then the heart rate is changing or you are misinterpreting the patient's pulse with your own. Is the heart rate regular? Are they on a monitor? Are they changing position when you take the pulses?


    You're funny! I was taking my own pulse! Took it on one arm with a blood pressure cuff, and then took it on the other arm with the blood pressure cuff. Everyone here, so far, thinks that I have something called pulsus differens or paradoxus or something.

    Thanks for the laugh!
  10. by   EarthAngel
    a pulse deficit?
  11. by   Palpitations
    Quote from EarthAngel
    a pulse deficit?
    Yep, I think that you're right. I found this little note on a website for doing cardiac assessments:

    APICAL RADIAL PULSE

    Checks Peripheral Perfusion
    One Nurse Checks Radial Pulse
    One Nurse Checks Apical Pulse

    Normal: Radial = Apical
    Poor Perfusion : Radial < Apical
    Pulse Deficit

    From: www01.homepage.villanova.edu
  12. by   Palpitations
    Well I had an EKG, a holter monitor test, and and echocardiogram. It took the doctors **** a month to read the tests. The print out on the EKG said that it could not rule out an anterior infarct. The doctor said that the EKG print out was wrong because there was some kind of problem with the leads or the computer, said the EKG was normal without ordering a second EKG. The next doctor reads the holter monitor report and says in the absence of hyperthyroidism that I should be worked up for "inappropriate sinus tachycardia" (IST). The third doctor read the echo and said that the echo was essentially normal, except for some calcification on the mitral valve (nothing to worry about) and for mild tricuspid regurgitation.

    So here I am. Sheesh. I don't know anymore than I did when I started this thread.

  13. by   Palpitations
    So here I am. Sheesh. I don't know anymore than I did when I started this thread.

    [/QUOTE]

    Oops! Yes, I do know more! I learned about pulse deficit, pulsus paradoxus, and pulsus differens!

    Yes, I talk to myself and I answer back!


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