What is the term for this condition?

  1. 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
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  2. 78 Comments

  3. by   suzanne4
    You only have one heart, so you cannot given two different pulse rates.
    Have you actually listened to your heart? I would advise checking your apical rate. You can get two different blood pressures because that has to do with the vascular system but two different heart rates, NO. The pulse is how many times per minute that the heart beats.
  4. by   Palpitations
    Quote from suzanne4
    You only have one heart, so you cannot given two different pulse rates.
    Have you actually listened to your heart? I would advise checking your apical rate. You can get two different blood pressures because that has to do with the vascular system but two different heart rates, NO. The pulse is how many times per minute that the heart beats.

    So, you're saying that there would not be a difference in pulses in conditions like Left or Right Ventricular Hypertrophy? Or in conditions that effect the lungs like pleural edema? Or any condition that would effect circulation...like a clot or something?

    Just wondering? Not trying to be argumentative.

    Thanks
  5. by   NeuroICURN
    Quote from Palpitations
    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
    I think what you MAY be referring to is pulses paradoxus. That's where the apical rate is different than that of the radial pulse.
  6. by   suzanne4
    Quote from Palpitations
    So, you're saying that there would not be a difference in pulses in conditions like Left or Right Ventricular Hypertrophy? Or in conditions that effect the lungs like pleural edema? Or any condition that would effect circulation...like a clot or something?

    Just wondering? Not trying to be argumentative.

    Thanks
    With a clot, the pulse would be weaker, or no pulse palpated. The clot causes a blockage in the artery. The if you have a clot in the forearm, your braichial artery could be quite strong, but the pulse that you try to palpate in your ulnar or radial artery would be weaker or not there. The heart doesn't pump at different rates, the muscle pumps as one, the atrial rate could be different, but what you are feeling is the ventricle pumping when you check the pulse. Nothing will cause a different pulse in each arm, blood pressure can vary because of differences in anatomy, etc. But the pulse will be the same.
    You may get a different rate when checking between apical and radial pulses because of ectopic beats, but not between both arms. At each moment, the pulse is the same in both arms and legs.
  7. by   Marie_LPN, RN
    Quote from Palpitations
    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
    I'll have an answer tomorrow after my physical. My left pulse is 72-75, right is 115-120.
  8. by   Palpitations
    Quote from suzanne4
    With a clot, the pulse would be weaker, or no pulse palpated. The clot causes a blockage in the artery. The if you have a clot in the forearm, your braichial artery could be quite strong, but the pulse that you try to palpate in your ulnar or radial artery would be weaker or not there. The heart doesn't pump at different rates, the muscle pumps as one, the atrial rate could be different, but what you are feeling is the ventricle pumping when you check the pulse. Nothing will cause a different pulse in each arm, blood pressure can vary because of differences in anatomy, etc. But the pulse will be the same.
    You may get a different rate when checking between apical and radial pulses because of ectopic beats, but not between both arms. At each moment, the pulse is the same in both arms and legs.
    I need to be able to take the pulses on my arms simultaneously! When I applied the BP cuff to my other arm, my blood pressure cuff gave a different reading for my pulse. It read 44 on the left arm and 106 on the right arm. Then later it read 64 on the left arm and 88 on the right arm. So, something strange is going on. I just don't know what it is. Could I be having changes in my heart rate that quickly (between the time it takes to move the cuff to the other arm)?

    And if so, why is the same arm consistently lower than the other?

    And one more question? What is a narrow pulse pressure? How many mmhg's difference does it take to be considered significant?

    Thanks
  9. by   jnette
    Quote from NeuroICURN
    I think what you MAY be referring to is pulses paradoxus. That's where the apical rate is different than that of the radial pulse.
    Yes.. I'm THINKING here... but isn't there a name for what she describes as well... different in each arm? I remember reading/studying about that as well... and too sorry to look it up right now. :imbar

    We'll just wait for Marie to reeducate us tommorrow after her appointment ! :chuckle
  10. by   unknown99
    Quote from suzanne4
    You only have one heart, so you cannot given two different pulse rates.
    Have you actually listened to your heart? I would advise checking your apical rate. You can get two different blood pressures because that has to do with the vascular system but two different heart rates, NO. The pulse is how many times per minute that the heart beats.
    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.
  11. by   suzanne4
    It isn't a different pulse, it is a different blood pressure.
    Your heart rate is going to very all of the time. Many people have a difference in BP in both arms because of their anatomy, this is not uncommon. By the time you put the cuff on the other arm, a few minutes has gone by, plus when you are applying it to yourself, you are not necessarily going to have it on exactly right on both sides.

    Try actually taking your own pulse with your fingers, on both arms, this will give you the most accurate numbers. Also, remember that your cuff is taking an average as it is counting.
  12. by   wonderbee
    Isn't the phenomenom called a pulse deficit? As I recall, my flowsheets have a space for bilateral pulse rates. They can indeed be different. It is normal for them to be ever so slightly different because of the circulation pattern. However, a really measurable difference indicates abnormality. I have encountered one very ill cardiac patient who had extremely different rates before death.
    Last edit by wonderbee on Jun 24, '04
  13. by   unknown99
    Quote from suzanne4
    It isn't a different pulse, it is a different blood pressure.
    Your heart rate is going to very all of the time. Many people have a difference in BP in both arms because of their anatomy, this is not uncommon. By the time you put the cuff on the other arm, a few minutes has gone by, plus when you are applying it to yourself, you are not necessarily going to have it on exactly right on both sides.

    Try actually taking your own pulse with your fingers, on both arms, this will give you the most accurate numbers. Also, remember that your cuff is taking an average as it is counting.
    Yes you can have a difference in BP, but YES, you can have a difference in pulse from side to side. I deal with this on a daily basis at work. Also, check your Taber's. It will explain it better... look under pulsus differens.
  14. by   kids
    I have had patients who, during a run of A-fib have significantly different right and left radial pulses when palpated by 2 nurses at the same time.

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