Pulsdefizit

Pulsdefizit, also known as pulse deficit, is a medical condition where the number of palpable pulses at a peripheral site, such as the wrist or ankle, is less than the number of heartbeats heard with a stethoscope at the apex of the heart. This discrepancy indicates that some of the heart's contractions are not generating enough force to propel blood effectively to the extremities, or that the pulse wave is not reaching the peripheral site.

The most common cause of pulsdefizit is atrial fibrillation, a type of irregular heart rhythm. In atrial fibrillation, the atria quiver instead of contracting effectively, leading to an erratic ventricular response and a pulse that is both irregular and often weak. Other cardiac conditions that can lead to pulsdefizit include severe valvular heart disease, particularly mitral stenosis or aortic stenosis, and certain arrhythmias like ventricular tachycardia.

Diagnosing pulsdefizit involves simultaneously taking a radial pulse at the wrist and listening to the apical pulse with a stethoscope. A significant difference between the two counts over a period of time, typically one minute, confirms the presence of a pulse deficit. Further investigations, such as an electrocardiogram (ECG), echocardiogram, or Holter monitor, are usually performed to identify the underlying cause.

Treatment for pulsdefizit focuses on addressing the root cause. If atrial fibrillation is responsible, treatments may include medications to control heart rate and rhythm, anticoagulants to prevent blood clots, and procedures like cardioversion or ablation. For valvular heart disease, surgical intervention may be necessary. Prompt diagnosis and management are crucial to prevent complications such as stroke or heart failure.