From the Guidelines
Bounding pulses are strong, forceful arterial pulses that can be easily felt and appear to push outward with excessive force against your fingertips during examination, rated as 3 on a scale where 0 is absent, 1 is diminished, and 2 is normal 1. They occur when there is a wide pulse pressure (the difference between systolic and diastolic blood pressure). Some key points about bounding pulses include:
- Common causes include aortic regurgitation, patent ductus arteriosus, arteriovenous fistulas, anemia, hyperthyroidism, and high-output states like fever or pregnancy.
- When examining for bounding pulses, healthcare providers typically check peripheral arteries such as the radial, carotid, or femoral arteries.
- The physiological mechanism behind bounding pulses involves increased stroke volume or rapid runoff of blood from the arteries, creating this characteristic forceful quality.
- If you experience bounding pulses, it's essential to seek medical evaluation as they may indicate underlying cardiovascular conditions that require treatment, and the diagnosis can be confirmed with diagnostic testing, such as the ankle-brachial index (ABI) 1.
- The specific management depends on identifying and addressing the root cause rather than treating the bounding pulse itself, and a thorough lower extremity vascular examination, including palpation of lower extremity pulses and auscultation for femoral bruits, is crucial in the clinical assessment for peripheral artery disease (PAD) 1.
From the Research
Definition of Bounding Pulses
Bounding pulses are a type of pulse that is characterized by a strong and forceful beat, often associated with a wide pulse pressure [ 2 ]. This means that the difference between the systolic and diastolic blood pressure is greater than normal, resulting in a pulse that feels strong and bounding.
Causes of Bounding Pulses
Bounding pulses can be caused by various conditions, including:
- Aortic regurgitation, a condition where the aortic valve does not close properly, allowing blood to flow back into the left ventricle [ 2 ]
- Systolic hypertension, or high blood pressure, which can cause the pulse pressure to increase [ 2 ]
- Other conditions that affect the heart or blood vessels, such as aortic insufficiency [ 3 ]
Characteristics of Bounding Pulses
Bounding pulses are often associated with the following characteristics:
- A wide pulse pressure, which is the difference between the systolic and diastolic blood pressure [ 2 ]
- A strong and forceful beat, which can be felt in the peripheral arteries [ 2 ]
- An increased cardiac output, which can be measured using echocardiography or other diagnostic tests [ 3 ]
Diagnosis and Treatment of Bounding Pulses
Bounding pulses can be diagnosed using various tests, including:
- Echocardiography, which can help to assess the function of the heart and the aortic valve [ 2 ]
- Blood pressure measurements, which can help to diagnose systolic hypertension [ 4 ]
- Other diagnostic tests, such as magnetic resonance imaging or cardiac catheterization, which can help to assess the condition of the heart and blood vessels [ 5 ] Treatment for bounding pulses depends on the underlying cause, but may include:
- Medications, such as vasodilators or beta blockers, which can help to reduce blood pressure and improve cardiac function [ 3 ]
- Surgery, which may be necessary to repair or replace the aortic valve [ 2 ]
- Lifestyle changes, such as diet and exercise, which can help to reduce blood pressure and improve overall health [ 6 ]