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Bounding pulses

Discussion in 'General Issues and Discussion Forum' started by Asher, Mar 31, 2008.

  1. Asher

    Asher Well-Known Member


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    Hi all,

    I asked this question a couple of weeks ago and got no response, I'm hoping its not that dumb a question.

    Is bounding pulses as heard via doppler assessment possible in a non-diabetic? If so, is it bad and what could it indicate?

    Thanks

    Rebecca
     
  2. Dido

    Dido Active Member

    Hello Asher,
    I am not too sure I understand your question as bounding pulses are felt rather than heard. However, the answers I think you want are YES and YES. A bounding pulse may suggest aneurysm and/or calcification and this factor should be taken into account when performing the patient's vascular assesment.
    Dido
     
  3. Asher

    Asher Well-Known Member

    Hi Dido,

    Thanks so much for your response. What is the bounding caused by? Does it just indicate increased arterial supply. If so, a simple musculoskeletal injury could give bounding pulses? Can something like an active inflammatory arthritic state cause a bounding pulse, or infection?

    I hope someone can clarify the feel vs sound thing for us as I'm pretty sure you can tell a bounding pulse from the doppler sound ...

    Thanks again

    Rebecca
     
  4. Johnpod

    Johnpod Active Member

    Hi Rebbeca

    The bounding pulse is associated with calcification of the arterial walls which become stiff and non-elastic. The 'bolus' or mass of blood from each heartbeat can be palpated as it passes the fingers and can even be seen in some cases. Doppler printout would show loss of the triphasic wave (demonstrating that there is no elastic recoil of the artery wall that would help to accommodate the pulse wave) and this feature can actually be heard through loudspeaker or earphones as a biphasic sound ('Library of Sounds' CD accompanies every Doppler machine sold by Huntleigh Healthcare and illustrates this well. Approach them and they will probably send you a copy).
     
    Last edited: Mar 31, 2008
  5. RussAgg

    RussAgg Active Member

    Hi Johnpod
    I thought bounding pulses were also associated with shunting of arterio-venous anastamoses; a phenomenon found in autonomic neuropathy.
    Regards, Russ.
     
  6. Ella Hurrell

    Ella Hurrell Active Member

    Russ

    Yes, I thought so too - autonomic neuropathy was something I was always taught to consider when finding bounding pulses

    Kind regards, Ella
     
  7. Dido

    Dido Active Member

    Hello Ella and Russ,
    Yes, you are both correct.
    Autonomic neuropathy presents with a very dry skin and fissures, especially aound the heels because of decreased sweating. Distended veins may also be present on the dorsum caused by arteriovenous shunting, leading to bounding pulses and a warm foot.
    Additionally, bounding pulses can also signify digitalis toxicity (a medical emergency), aspirin overdose, hypertension, aortic fibrillation, hyperthyroidism and fluid overload. Fluid overload can occur with cardiac failure, aortic valve regurgiataion and chronic kidney failure
    However, it is worth mentioning that bounding pulses occur quite naturally in pregnancy, high anxiety and heavy excercise.
    Dido.
     
  8. Admin2

    Admin2 Administrator Staff Member

  9. Dean Hartley

    Dean Hartley Active Member

    I was under the impression, in a normal artery, the sympathetic nervous system has an over-riding vasoconstrictive action on the vessel. In autonomic neuropathy this vasoconstriction is reduced, resulting in the bounding pulse.?
     
  10. Asher

    Asher Well-Known Member

    Can someone please explain to me what arteriovenous shunting is all about? I realise it means that blood travels from an artery straight to a vein, which is bad because the blood can not deliver its oxygen to cells and so the heart has to work harder pumping blood around. I thought blood travels by default from artery - arteriole - capillary - venule - vein. Are there normally occurring arteriovenous shunts or do they develop with disease eg: diabetes? And where does the word anastomosis come into it?

    Thanks!
     
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