Auscultation and pulse simultaneously

There is also a more erotic version - auscultation with checking pulse on apex) Unfortunately, I saw it only on video.

It's pretty common here, and I love it!

I had it done by different doctors, but at the wrist only, never on carotid like I see on most teaching videos

My doctor always does this. I have mild cardiomyopathy so any pulse deficit is important to detect/monitor. She/he palpates my radial pulse most usually, but that can be difficult sometimes so then it's the carotid.

I've had this done once. An older female doctor I've never seen before. It was very quick but definitely a first for me. It's never happened since

Listening to the apex and palpating a brachial or carotid pulse is used to check for possible atrial fibrillation. Since the atria are only twitching the stroke volume (blood ejected from the ventricle in one beat) can vary. With a low stroke volume the peripheral pulse may be absent when a distinct systolic sound can be heard. It then can be confirmed with an EKG.

Two other clinical problems that can be picked up by simultaneously auscultating and checking the pulse. Pulsus paradoxicus is when the pulse pressure decreases abnormally during inspiration..It normally drops a bit but if the pulse disappears during inspiration one must suspect a severe decrease in ventricular filling with inspiration. The cause of this I recall off the top of my head is cardiac tamponade (in which the heart sounds might sound abnormally distant as well). There are others. The other manifestation (that strictly speaking does not require simultaneous auscultation) is pulsus alternans when every other beat has a much decreased amplitude. Can be manifested in cardiomyopathies as well as other conditions. Others feel free to comment -- it's been a long time!

Thanks rayme. Pulsus paradoxus is heard when listening for blood pressure. The korotkov sounds disappear when the patient breaths. 10cm of mercury is a normal pulsus paradoxus but more than that is abnormal. It is found with pericardial tamponade and also commonly in COPD. Pulsus alternans occurs with LV dysfunction as in cardiomyopathy and carries an ominous prognosis.

Omg - having my pulse checked whilst being stethed is an absolute fantasy of mine. I think if a doctor did that to me I'd be so turned on he wouldn't be able to help but notice....fast heart rate, accelerated breathing, hardened nipples....gentle whimpers emanating from his patient.... ???

Once I was at the doctor, there was a medical student. While the doctor listened to my heartbeat, a sexy medical student measured my blood pressure. We switched them.

Ohhh ... It was the best one visit to the doctor.

Only last week, during a check up and following an ECG, the practitioner listened to my heart whilst checking the pulse in my wrist.

I do it everytime...it is the best way to hear and feel the beats of the heart at the same time. You can also usually look at the patient's carotid lying down during auscultation. This way you have three senses used !

Dr.MG

Ive actually never experienced this but it sounds like a thorough concept!

I've had a couple steth-buddies do it while listening to my heart.

I have had a nurse do this when getting vitals, checking my pulse. I think I have a had a doctor do it while checking my heart come to think of it.

I often feel my patients radial pulse while taking blood pressure. I tuck the stethoscope under the cuff and simultaneously ausculate the brachial artery. All my patients are hypertensive females.