Physical examination maneuver

Physical Exam

Carotid Artery Palpation

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How to Perform

With the patient's neck relaxed, gently palpate one carotid artery at a time low in the neck. Assess the pulse's amplitude, contour, rapidity of upstroke, rate, and rhythm.

How to Interpret

Showing 2 of 13 findings

Aortic Stenosis

Slow-rising (parvus et tardus) carotid pulse
Rule in
Helpful
Rule out
Somewhat helpfulWide CI
Evidence:Strong

Takayasu Arteritis

Diminished or absent carotid pulse, or carotid tenderness
Rule in
Helpful
Rule out
Not helpful
Evidence:Moderate

Related Bedside Tests

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Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
Cardiac AuscultationMembers
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Cardiac Auscultation
Rule in:VHAortic Stenosis, VHHeart Failure, VHHypertrophic Cardiomyopathy +37 more
Rule out:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHRight-sided Valvular Lesion +37 more
🎬Video coming soon
Point of Maximal Impulse
aka Apical impulse; apex beat
Rule in:VHAortic Stenosis, VHHypertrophic Cardiomyopathy, VHLeft Ventricular Dilation +14 more
Rule out:VHAortic Stenosis, VHLeft Ventricular Dilation, SHLeft Ventricular Hypertrophy +14 more
Heart RateMembers
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Heart Rate
Rule in:SHAtrial Fibrillation, SHDecompensation, SHHypothyroidism +15 more
Rule out:HDecompensation, SHAtrial Fibrillation, SHPostoperative Complication +15 more
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Jugular Venous Pressure
Rule in:VHShock, HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure +14 more
Rule out:HRight Ventricular Infarction, SHElevated Pulmonary Capillary Wedge Pressure, SHPulmonary Hypertension +14 more
Respiratory RateMembers
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Respiratory Rate
Rule in:HReduced Left Ventricular Ejection Fraction, SHCardiopulmonary Arrest, SHPneumonia +10 more
Rule out:MHCardiopulmonary Arrest, MHPulmonary Embolism, NHPneumonia +10 more

Related Systems / Regions

CardiovascularNeck

Related Diagnoses

Acute Aortic DissectionAortic RegurgitationAortic StenosisCardiac TamponadeCarotid Artery StenosisCarotid DissectionHyperdynamic StateHypertrophic CardiomyopathyHypotensionMixed Aortic Valve DiseaseReduced Left Ventricular Ejection FractionTakayasu Arteritis

Related Chief Complaints

Abdominal PainAnxietyArm ClaudicationArm Fatigue with UseArm PainBack PainBalance ProblemsChest DiscomfortChest PainChest PressureChest TightnessChillsCold ExtremitiesConfusionCoughDiarrheaDifference in Arm Blood PressureDifficulty SpeakingDifficulty WalkingDizzinessDouble VisionDrooping EyelidEpigastric PainExercise IntoleranceExertional Chest PainExertional DyspneaFacial DroopFatigueFeverFlushingHeadacheHeart MurmurHeat IntoleranceIncidental FindingJaw PainLeg SwellingLightheadednessLow Blood PressureNauseaNeck BruitNeck PainNeck SwellingNight SweatsNumbness on One SideOrthopneaPain Radiating to the BackPalpitationsParoxysmal Nocturnal DyspneaPounding HeartbeatShortness of BreathSlurred SpeechSmall PupilSudden Vision LossSweatingSyncopeTearing Chest PainTransient NumbnessTransient Vision LossTransient WeaknessTremorVision ChangesWarmthWeaknessWeakness on One SideWeight GainWeight LossWheezing

References

  • Ohle R, Kareemi HK, Wells G, Perry JJ. Clinical Examination for Acute Aortic Dissection: A Systematic Review and Meta-analysis. Acad Emerg Med. 2018;25(4):397-412. doi:10.1111/acem.13360. PMID: 29265487.
  • Azoyan L, et al. Diagnostic Accuracy of Clinical Findings for Takayasu Arteritis: A Rapid Review and Meta-Analysis. Int J Vasc Med. 2025;2025:6092362. doi:10.1155/ijvm/6092362. PMID 40963697. PMC12440657 (open access).
  • Azoyan L, et al. Diagnostic Accuracy of Clinical Findings for Takayasu Arteritis: A Rapid Review and Meta-Analysis. Int J Vasc Med. 2025;2025:6092362. PMID 40963697. PMC12440657 (open access).
  • Choudhry NK, Etchells EE. The Rational Clinical Examination. Does this patient have aortic regurgitation? JAMA. 1999;281(23):2231-2238. PMID: 10376577. (Closest candidate only — does not anchor a tier above IE.)
  • Shellenberger RA, Crass S, Jevicks J, Badhwar A, Albright J, Kumar A. Bedside Physical Examination for the Diagnosis of Aortic Stenosis: A Systematic Review and Meta-analysis. CJC Open. 2023;5(5):373-379. doi:10.1016/j.cjco.2023.02.007. PMID: 37377515; PMCID: PMC10290951.
  • Fatema N, Mandal RM, Arzu J, et al. Objective evidence of pulsus alternans by echocardiography in acute severe heart failure. Univ Heart J. 2020;16(2):92-98.
  • Deakin CD, Low JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. BMJ. 2000;321(7262):673-674. doi:10.1136/bmj.321.7262.673. PMID: 10987771.
  • Roy CL, Minor MA, Brookhart MA, Choudhry NK. Does this patient with a pericardial effusion have cardiac tamponade? JAMA. 2007;297(16):1810-1818. PMID: 17456823.
  • McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 9, 2026.