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Cardio Exam

Pulse Delay

July 1st, 2020


Whether a delay occurs between two radial arteries or between the radial artery and femoral artery depends on whether the lesion is proximal or distal to the branching of the left subclavian.

Radio-Radial Delay

If present, a delay between bilateral radial pulses suggests narrowing of the aorta proximal to the left subclavian artery - classically in the context of coarctation of the aorta.
  • How to Elicit

  • Palpate bilateral radial pulses at the same time.
If the left radial pulse is slightly later than the right, then radio-radial delay is present.
  • Radio-Radial Delay
  • Causes of Radio-Radial Delay

  • Aortic coarctation
  • Subclavian stenosis
  • Takayasu arteritis

Radio-Femoral Delay

A significant delay between the radial and femoral pulse suggests aortic coarctation distal to the left subclavian artery.
  • How to Elicit

  • Palpate the radial and femoral pulses (on the left or right) at the same time. If there is radio-femoral delay, the femoral pulse will be slightly later than the radial pulse.
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