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An absent carotid pulse may indicate critical aortic stenosis

Department of Cardiac Surgery, Royal Victoria Hospital, Grosvenor Road, Belfast, Northern Ireland BT12 6 BA, UK

^* Corresponding author. Tel.: +44-2890-263-000; fax: +44-2890-894-918
simon.macgowan{at}royalhospitals.n-i.nhs.uk

In severe valvular aortic stenosis, obstruction to ventricular contraction results in prolonged ventricular systole and diminished peak flow velocity. This may translate into weak or impalpable peripheral arterial pulses. We report a case of severe aortic stenosis associated with an impalpable carotid pulse (in the absence of local carotid artery disease) that became easily detectable following aortic valve replacement. In the presence of an aortic stenosis murmur, a weak or impalpable carotid pulse is indicative of critical aortic stenosis and warrants urgent investigation.

Key Words: Aortic stenosis; Absent carotid pulse; Duplex imaging