Pulse - weak or absent

• Alternative Names

  Weak pulse; Absent pulse

• Considerations

  An absent or weak pulse may affect all or one part of the body.

  If a pulse cannot be detected by a non-medical professional, it doesn't always mean there is a problem. Sometimes, it can be hard for a non-medical person to detect a pulse in certain areas.

• Common Causes
  • Cardiac arrest (lack of an effective heartbeat)
  • Improper technique used to feel for the pulse
  • Normally weak pulse that is difficult to measure without proper instruments
  • Shock
• Home Care

  Follow the treatment your health care provider prescribes. CPR may be necessary.

• Call your health care provider if

  Call your health care provider if there is any sudden, severe, or long-lasting decrease in the pulse quality or rate, particularly when there are also other symptoms.

  Shock is a life-threatening condition. Seek immediate medical help if you think someone has gone into shock. Start CPR, if needed.

  A loss of consciousness or disorientation suggests that there is not enough blood getting to the brain. Seek medical help immediately.

• What to expect at your health care provider's office

  Your medical provider will take a medical history, do a physical exam, and ask questions such as:

  • Is the pulse weak?
  • Is it absent?
  • Is the pulse weak or absent in only one location?
  • Is a major pulse weak or absent (for example, when checking the carotid pulse in the neck)?
  • What other symptoms are present?

  Physical examination may include monitoring the vital signs (pulse, rate of breathing, blood pressure). Emergency measures will be taken as necessary. Continued monitoring may be necessary.

  Diagnostic tests may include:

  • Aortography
  • Arteriography such as extremity arteriography
  • Blood studies (CBC or blood differential)
  • Doppler ultrasonography
  • ECG
  • Echocardiography
  • X-rays of the chest
• References

  Fang JC, O'Gara PT. The history and physical examination: an evidence-based approach. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 11.

  Schriger DL. Approach to the patient with abnormal vital signs. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa:Saunders Elsevier;2007:chap 7.

Review Date: 2/22/2009

Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.