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Unequal pulses

  • Ddx

    • coarctation of aorta, Turner's syndrome
    • fistula, dialysis arm
    • severe atherosclerosis
    • thoracic outlet syndrome
    • subclavian steal
  • Serious

    • aortic dissection
    • aneurysm
    • arterial embolism
    • fracture with vascular compromise
  • Labs

    • ankle-brachial index if suspect chronic atherosclerosis
    • xray if suspect fracture
    • if acute onset:
    • EKG, serial enzymes
    • angiography
    • echo to r/o mural thrombus
    • consult cardiovascular surgery

  • Print | Citations

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