Heart Sounds Research Lab
The Heart Sounds and Murmurs Laboratory | 6560 Fannin St, Suite 1836| Houston, Texas 77030 | 832-355-2937
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The arterial pulse in patients with hypertrophic obstructive cardiomyopathy (HOCM) may be characteristic of the diagnosis. The arterial pulse is bisferan (pulsus bisferiens) with a rapid-rising initial systolic pulsation, the percussion wave, followed by a gentler second swell, the tidal wave. Both of these positive pulses occur during systole. The percussion
wave occurs during the period of relatively unimpeded, hyperkinetic early systolic ejection. The tidal wave occurs during the period of reduced systolic ejection and greater outlet obstruction of late systole.
Hypertrophic Obstructive Cardiomyopthy