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.
Radio radial 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
To detect the radio-femoral delay, you should palpate the radial and femoral artery simultaneously Normally there is no radio-femoral delay .
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.
Carotid =30 Milliseconds
Brachial =60 Milliseconds
Femoral =75 Milliseconds
Radial =80 Milliseconds