1. ❑ Irregularly irregular pulse
   1. atrial fibrillation
   2. PVCs, PACs
   3. multifocal atrial tachycardia.
2. ❑ Asymmetric pulses
   1. subclavian artery atherosclerosis,
   2. arterial thrombosis
   3. thoracic outlet compression,
   4. aortic dissection.
3. ❑ Bounding pulse
   1. Increased pulse pressure
      1. Decreased vascular compliance
      2. Increased cardiac output
         1. thyrotoxicosis
         2. pregnancy
         3. fever
         4. patent ductus arteriosus
         5. arteriovenous fistula
      3. decreased peripheral resistence
   2. aortic regurgitation
4. ❑ pulse pressure
   1. Hyperkinetics
      1. Bounding pulse
   2. Hypokinetics
5. ❑ Bisferiens pulse
   1. hypertrophic cardiomyopathy
   2. combined aortic stenosis and regurgitation
6. ❑ Bigeminal pulse
   1. regular VPCs
7. ❑ Pulsus alternans
   1. hypertrophic obstructive cardiomyopathy.
8. ❑ Pulsus paradoxus
   1. Decreased systolic pressure during inspiration accentuated(>10mmhg)
   2. Constrictive cardiomyopathy
   3. Cardiac temponade
9. ❑ Pulsus parvus
   1. decreased LV stoke volume
   2. Increased peripheral vascular resistence
10. ❑ Pulsus tardus
    1. Obstruction of LV