● The amplitude of the pulse. This correlates reasonably well with the pulse pressure.
● The contour of the pulse wave, namely the speed of the upstroke, the duration of its summit, and the speed of the downstroke. The normal upstroke is brisk; it is smooth, rapid, and follows S1 almost immediately. The summit is smooth, rounded, and roughly midsystolic. The downstroke is less abrupt than the upstroke.
● Any variations in amplitude, either from beat to beat or with respiration.
● The timing of the carotid upstroke in relation to S1 and S2. Note that the normal carotid upstroke follows S1 and precedes S2. This relationship is very helpful in correctly identifying S1 and S2, especially when the heart rate is increased and the duration of diastole, normally longer than systole, is shortened and approaches the duration of systole.
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