Radio Femoral Delay



Hello :)
Before this post I didn't realise the importance of checking and comparing both the radial pulses.
Pulse, by definition, is the expansion and elongation of the arterial wall imparted by the column of blood, passively produced by the pressure changes during ventricular systole and diastole.
Always report the pulse under following headings.
Assessment of pulse include :-
1. RATE (beats/min)
-Tachycardia (>100bpm)
-bradycardia (<60bpm)
2.RHYTHM
-regular
-regularly irregular (2nd degree heart block)
-Irregularly irregular (Atrial fibrillation, ventricular premature beat)
3.EQUALITY
4.CHARACTER
5.PERIPHERAL PULSES
6.APEX PULSE DEFICIT (atrial fibrillation )
7. RADIO RADIAL /RADIO FEMORAL DELAY
Today , I will discuss the causes of Radio Radial and Radio Femoral delay.
CAUSES OF RADIO RADIAL DELAY :-
1. Normal anatomical variations
2. Thoracic inlet syndrome, e.g. cervical rib
3. Aneurysm of Arch of aorta
4. Presubclavian coarctation
5. Supravalvular aortic stenosis
6. Pulseless disease
7. Peripheral embolism or artheromatous plaques
8. Artherosclerosis of aorta
9. Pressure over axillary artery by lymph nodes
10. Iatrogenic, Blalock-Tausig shunt operation in TOF
CAUSES OF RADIO FEMORAL DELAY :-
1. Coarctation of aorta
2. Artherosclerosis of aorta
3. Thrombosis or embolism of aorta
4. Aortoarteritis
That's all for today,
-Upasana Y. :)

Radio-femoral delay = occlusion of the aorta arterial bruit = partial vessel occlusion or turbulent blood flow. Describe the volume and character of relevant pulses on examination. Volume can reflect pulse pressure, and increased volume can be pathogenic or physiological. To detect the radiofemoral delay you have to palpate the radial and femoral artery simultaneously.Normally the time taken for the pulse wave to reach the radial artery after the cardiac systole is 80 milliseconds and for the femoral artery it is 75milleseconds.If the femoral pulse is delayed compared to radial pulse it is called as radiofemoral delay. Posted in Cardiology - Clinical, great illustrations in cardiology, tagged anterior spinal artery, aorta, co arctation of aorta, coarctation of aorta, collaterals in coarctation, inferioor epigastric artery, inferior epigastric artery, intercostal artery, jesse edwards, radio femoral delay, sub scapular artery, vertebral artery on April 7, 2009. Radio-femoral delay a sign that collateral circulation has developed to.On the other hand, a coarctation occurring after the left subclavian artery will produce synchronous radial pulses, but radial- femoral delay will be present under. 8 Condition of arterial wall 2. 3 Patterns 4 Common palpable sites.

Cardiology , general examination , notes , practical notes , pulse , vitals monitoring
Normal situation radial and femoral pulsations are felt equally and synchronously.The inequality between two radial pulses is known as Radio radial delay.The delay between the radial pulse and femoral pulse is called as Radiofemoral delay.
To detect the radioradial delay you should simultaneously palpate both the radial arteries by both your hands, using your left hand for patients right radial artery and vice versa
Following are the causes of radio-radial delay
  • Normal anatomical variations.
  • Thoracic inlet syndrome e.g. cervical rib. scalene syndrome.
  • Aneurysm of the aorta.
  • Pre-subclavlan coarctation.
  • Supravalvular aortic stenosis.
  • Pulseless disease (Takayasu's disease).
  • Peripheral embolism.
  • Atherosclerosis of aorta.
  • Pressure over axillary artery by tumour, lymph nodes etc
What is radiofemoral delay and what are its causes?
To detect the radio-femoral delay, you should palpate the radial and femoral artery simultaneously Normally there is no radio-femoral delay .
Delay of the femoral compared with the right radial pulse is found in coarctation of the aorta
Causes of radio-femoral delay are the following
  • Coarctation ol aorta (It is an important bedside diagnostic clue in a young hypertensive).
  • Atherosclerosis of aorta.
  • Thrombosis or embolism of aorta.
  • Aortoarteritis.

Preductal Vs Postductal Coarctation


Time at which pulse wave arrives after cardiac systole in artery

What Is Radiofemoral Delay


Carotid=30 Milliseconds

Radiofemoral Delay In Hypertension

Brachial =60 Milliseconds
CoarctationFemoral =75 Milliseconds
Radial =80 Milliseconds


Previous Section : What is the mechanism of radiofemoral delay?
Next Section : What are the basic bedside features of coarctation of aorta ?
How to examine for radiofemoral delay an OSCE guide




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