Arterial Pulse

Abstract

The evolution of quantitative methods of arterial pulse analysis paralleled a gradual devolution of the art of arterial pulse diagnosis from its elevated status in antiquity to a basic clinical skill of assessing the pulse for ``rate and rhythm.'' In this chapter, a historical overview of pulse diagnosis is given and contrasted with the advent of analytical techniques of arterial waveform analysis in time and frequency domains. The discovery of ``standing waves'' suggested that the arteries form a resonant system driven by the heart. Experimental evidence for active aortic contractions supports this view. The dichotomy of pressure and flow waves as they propagate to the periphery is expressed by greater velocity and increase in amplitude of the former and by slower velocity and decrease in amplitude of the latter. Available mathematical methods of modeling the arterial wave dynamics include the Windkessel model, Fourier analysis, wave intensity, and harmonic analysis. Strengths and limitations of each method are discussed in the context of experimental physiology and clinical medicine.