Missing pulse

[Loose rivets]

By Missing pulse, I mean just missing, nothing, nada, in the Rivetess' left wrist. Well, maybe the vaguest hint if you really poke around.

Testing for BP showed a low reading on her left arm, while normally she has a constant high BP.

She is taking a prescribed Calcium channel blocker, which has reduced the reading down to between 140-160 systolic down from explosively high.

At 62, she is more than active, taking over the role of surrogate mother from her busy children's little'uns.

There is no discomfort, no loss of strength--I asked her to grip my wrist and it b@@dy hurt--just no symptoms, other than it's almost impossible to detect the said pulse.

[Lionel Hutz]

not a doctor but a friend who is a cardiologist told me of a similar case over a few pints the other night, it was unusual but was put right with minor surgery, his patients arm had gone blue. Best get her checked out sharpish.

[gingernut]

There are weird and wonderful problems to do with the aorta which could possibly cause such symptoms, but in the abscence of other symptoms I'd be very surprised if their is anything serious going on here.

A quick check by a knowlegeable quack and his stethoscope should be able to put your mind at ease.

Do you make a habit of feeling for your wifes pulses?

[Loose rivets]

Mmmm, funny thing about the Rivetess...when we were courting, I would often hear her heartbeat -- whilst in a heartbeat hearing position. It stopped quite frequently. When I say stopped, I mean stopped: the sort of stopped that made me jump up and reach for my book of other girlfriend's numbers. :} But it would always fire up again and go back to just plain irregular.

When we had kids, she entered the mother's race against some of the local sporty type mums. These were very competitive women, yet, without any training, she left them all standing. But with her irregular heartbeat it's doubtful that she would have been able to hold a Class 10 medical.

When I posted on this forum about her reluctance to take any medication whatsoever, unless it was advertised in "Pills for Aging Vegetarians." Folk came back with the dangers of ignoring high blood pressure. Finally, after reaching explosive pressures, she started on the aforementioned tablets.

If I think about the hydraulics involved, I can not come to any real theory as to why this is happening, it just seems impossible that there should be no other symptoms. It might mean she has to head home with me for a full service.

Sheeeeeesh, old age sucks.

[Lancastrian]

Hope you dont mind my five penneth...new to the site but a pre-retirement background in medical and psychiatric nursing.

Sometimes on over zealous "pulse taker" can quite easily collapse a distal pulse in an elderly person. Usually there are other signs and symptoms for impending problems ie, tingling in the fingers could herald a Raynauds phenomonen or a carpal tunnel syndrome would ellicit quite a degree of pain and swelling. Sclerosing of the artery could be another possibilty. The recieving end of the arterial flow...the hand would possibly give an indication in colour change,temperature and function etc.

[Loose rivets]

I'd wondered about that, but since there are no other symptoms, I would have thought that it would have regained its shape. The Rivetess is your age and certainly has raised blood vessels on the back of her hand and a mother that had a serious heart problem at about 50.

When I compare the left with the right wrist, there is now just a hint of a pulse on the left, and loud and clear on the right.

She's not too sure about the results of the arm band machine, we're going to borrow it again tonight so will post again later.

[Loose rivets]

Borrowed son's bigger machine and found that the absence of pulse was true for the upper arm. It was, nothing there either.

She rarely fusses about herself, but this has got her attention. The doctor here and he suggested changing from calcium channel blocker a beta blocker, but she reads the fine print. One of the things that seem to be a no-no with the beta blocker is an irregular heart beat! She's thinking of going back to the CCB. Back to square one.

Does anyone think that the CCB might be causal in the missing pulse? And are there any links to the aorta problem that give a clear indication of the mechanics of the problem?

She is heading back home, since I have to be resident there anyway to comply with the NHS rules. Two grand parents down in one go would be tedious for the kids, we've made ourselves indispensable. :(

[gingernut]

I think you need to clarify the problem-

do you mean the pulse is totally absent? ie you can feel nothing.

or is there an irregularity? (totally different thing).

[aussiepax]

I would suggest she consult a cardiologist. The two problems may be unrelated. The absent pulse (asymptomatic) at the wrist could even be a congenital absence of the radial artery, even though the ulnar artery at the other edge of the wrist is fine. If the pulse is absent higher in the arm, or diminished, we would think of causes of relative obstuction higher up e.g narrowing (stenosis) of the subclavian artery . Medication alone should not cause any difference in pulse pressure between right and left.

The missed beats may just be innocent ectopics from the heart, but important causes such as atrial fibrillation would be diagnosable by cardiologist with ECG (EKG) and / or continuous Holter Monitor.

[Loose rivets]

Thanks for the replies.


Her irregular pulse has been with her for most of her life. As mentioned in the first post, it can be very severe but has never affected her (high level of) fitness.

This missing pulse is new.

The loss of pulse in her left arm is very, very near to being none. Tiny traces can be felt, but the machine(s) just read nonsense.

Blood has to be getting there because of the strength of her arm and the grip of her hand. If one wasn't looking for a pulse, one would never know anything was wrong.

One is mystified.

[obgraham]

I'm with aussiepax. Fit or not, it seems to represent a recent change. Rather than messing with an amateur diagnosis, best to get it checked out properly. Some sort of upstream abnormality needs to be ruled out.
Cardiologist. Soon, please.

[Loose rivets]

Thanks again. Yes, we are on our way home. It's been an odd Christmas visit to the most southern kids, me having been diagnosed with prostate cancer, and Mr LR with the above anomaly. We wern't due home until April and friends are in our usual flat, so it really has made things tricky accommodation wise. Ah well, such is life.