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Quincke's pulse

Etiology: - chronic aortic insufficiency (AI) - spider bite Pathology: - wide pulse pressure with large systolic stroke volume & rapid fall in arterial pressure Clinical manifestations: - prominent pulsations of skin capillaries - diastolic blanching in the nail bed with nail compression (AI) - tips of the index finger & thumb & the nail bed of the thumb exhibit capillary pulsation (AI) - dyspnea (AI) - edematous erythematous plaque pulsating with alternating erythema & blanching in synchrony with pulse (spider bite - image & video [4]) Special laboratory: - echocardiography Management: - aortic valve replacement (AI) - antihistamine for spider bite [4]

Related

aortic insufficiency (AI)

General

sign/symptom arterial pulse

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 260-61
  2. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, American College of Physicians, Philadelphia 1998, 2006
  3. Michelena HI, Enriquez-Sarano M Corrigan's Pulse and Quincke's Pulse N Engl J Med 2018; 379:e9. Aug 2, 2018 PMID: 30067925 https://www.nejm.org/doi/full/10.1056/NEJMicm171535
  4. Gal MS, Greenberger S Images in Clinical Medicine. A Pulsating Leg. N Engl J Med 2021; 384:e8 PMID: 33503345 https://www.nejm.org/doi/full/10.1056/NEJMicm2022429