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Arterial Pulse and Blood Pressure 41
2. Backflow or regurgitation of blood into the left
ventricle from the aorta (as in aortic regurgitation).
17. What is meant by pulsus bigeminus and pulsus
trigeminus?
Two important causes of regularly irregular pulse
are pulsus bigeminus and pulsus trigeminus. Pulsus
bigeminus is a cardiovascular phenomenon characterized
by groups of two pulse waves close together followed by
a long pause. The second pulse is weaker than the first,
and this phenomenon is caused by premature regular
ventricular ectopics that follows every normal beat.
Similarly, pulsus trigeminus consists of groups of three
pulse waves close together followed by a long pause, and
the every third pulse in the group is weaker than the first
two pulse waves (Fig. 8).
Fig. 8: ECG of a person with pulsus bigeminus
18. How will you differentiate irregularly irregular pulse
due to atrial fibrillation from that due to multiple
ventricular ectopics?
The two important causes for irregularly irregular pulse
are atrial fibrillation and multiple irregular ventricular
ectopics. The important differentiating features between
the two are the following (Table 3):
