The very fact that I had a bit of difficulty palpating our the carotid arterial pulse tells us something. This is an hypokinetic pulse and that is reflected by the excursion of the tip of the cotton swab that we'll share together here. [Cut-away]
In addition, the fact that that is a hypokinetic feeling pulse fits well with the observation on the blood pressure. You will recall that the pulse pressure was narrow.
Normal vs. Hypokinetic Graphics
By comparing the graphic of a normal patient to our patient, we can appreciate that our patient’s carotid arterial pulse has a small amplitude. The decreased amplitude of the hypokinetic arterial pulse may reflect a decreased stroke volume during left ventricular contraction. This, in turn, can be related to a decreased preload, or filling volume, or poor left or right ventricular function. A small, or hypokinetic pulse, may also be present with outflow tract obstruction.