Our patient's carotid impulse was not easy for me to feel initially. That, in itself, suggests a reduced amplitude. Now, let's confirm that together, again, using the cotton swab. Let's all observe the amplitude together. [Cut-away]
What do we think of when our patient has a reduced amplitude carotid arterial pulse? 1) think obstruction at some level; 2) reduced cardiac output, or it could be a combination of the two.
Normal vs. Hypokinetic Graphics
By comparing the graphic of a normal patient to our patient, we can appreciate that our patient’s carotid arterial pulse has a small amplitude. The decreased amplitude of the hypokinetic arterial pulse may reflect a decreased stroke volume during left ventricular contraction. This, in turn, can be related to a decreased preload, or filling volume, or poor left or right ventricular function. A small, or hypokinetic pulse, may also be present with outflow tract obstruction.