Next, we’ll evaluate our patient’s carotid arterial pulse. I’m putting light pressure on the vessel located just medial to the sternocleidomastoid muscle, and to share the observations I’m making with you, I’m going to use the cotton swab and we’ll observe the carotid pulse for its upstroke, peak, and downstroke. Everybody observe together.

Our patient’s carotid arterial pulse is normal in upstroke, peak, and downstroke.

Examination of the arterial pulses is very important in a patient presenting with chest pain, as the pulse may be a clue to either the severity of the problem or a specific diagnosis. For example, in a patient with an acute myocardial infarction that is large or a large pulmonary embolism, cardiac output could be reduced, and the pulse may become hypokinetic. In a patient with dissection, there might be a difference in the arterial pulse from the right to the left side, and this also can be correlated with the patient’s blood pressure. There might be a difference in the blood pressure, or a low blood pressure.