Physical Exam

Carotid Artery Palpation

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Video coming September 2026

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

Aortic Stenosis

Moderate-to-severe Aortic Stenosis

Slow-rising (parvus et tardus) carotid pulse

Rule in

Helpful

Rule out

Somewhat helpful

Evidence:Strong

Takayasu Arteritis

Diminished or absent carotid pulse, or carotid tenderness

Rule in

Helpful

Rule out

Not helpful

Evidence:Limited

References

Research in progress on one or more findings above; ratings may change.

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.