Bounding Pulse
Large bounding pulses are seen in aortic insufficiency and other high-output states, such as thyrotoxicosis, severe anemia, right-to-left shunt, and wet beriberi.
Patient 1:
This is a young man with intravenous drug use who was admitted to the hospital with infective endocarditis of the aortic valve resulting in severe aortic regurgitation.
This patient also has a decrescendo diastolic murmur over Erb’s point, an Austin Flint murmur over the apex, and Cheyne-Stokes respirations.
Patient 2:
This is an older man with aortic valve endocarditis.
Patient 3:
This is an older man with an aortic root aneurysm complicated by moderate to severe aortic regurgitation.
This patient also has a decrescendo diastolic murmur over Erb’s point, Corrigan’s pulse, bisferiens pulse, and de Musset’s sign.
Patient 4:
This is a middle-aged man with a high output state from liver disease. Right heart catheterization revealed a cardiac output of 11.5 L/min.
This patient also has palmar erythema and Dupuytren’s contracture.
Patient 5:
This is a middle-aged woman with aortic valve endocarditis.