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High volume jerky pulse (Spike and Dome Pulse)

It is seen in HOCM It is the only obstructive cardiac lesion producing high volume pulse due to the dynamic obstruction of LV outflow tract. Jerky pulse resembles Bisferiens pulse.
Mechanism of jerky pulse
  • In the Initial phase there is  no obstruction – stroke volume is high
  • During the maximal ejection phase there is obstruction to ejection of stroke volume resulting in  reduced stroke volume.
  • In the late phase there is relaxation so the obstruction is relieved and stroke volume again increase