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High volume pulse and its causes

High volume pulse is characterised by pulse pressure >60 mm of Hg.
This may be noticed in hyperkinetic states or atherosclerosis
The basic mechanism of high volume pulse is rapid run off of blood from arterial system either to heart, corresponding vein or to capillaries

At cardiac level - Aortic regurgitation(AR)
At Aortic level  - Patent Ductus A rteriosus(PDA)
At arterial level - Arteriovenous fistula

At capillary level- opening up of all capillaries on demand seen in anemia, high fever, thyrotoxicosis, beriberi, cirrhosis liver.

Hyperkinetic circulatory stales like.
  • After exercise.
  • Pyrexia
  • Severe anaemia.
  • Aortic incompetence.
  • Thyrotoxicosis.
  • Arteriovenous communication like patent ductus arteriosus (PDA). Paget's disease etc.
  • Chronic corpulmonale.
  • Hepatocellular failure.
  • Beri-beri.
In this condition the arteries are rigid, i.e. less compliant: hence there is wide pulse pressure as the systolic blood pressure is high.