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May 26, 1923


JAMA. 1923;80(21):1520. doi:10.1001/jama.1923.26430480001009

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  1. Sinus arrythmia is the common irregularity of the young; premature contractions cause the common irregularity of those past middle life.

  2. The absence of a predominant rhythm indicates auricular fibrillation.

  3. Comparison of the heart rate, as determined by auscultation with the pulse rate, will show a pulse deficit in all conditions excepting heart block and sinus arrhythmia.

  4. When the pulse rate is increased by exercise, the irregularity is decreased or made to disappear when caused by premature contractions or sinus arrhythmia, and is increased in auricular fibrillation.

  5. Deep breathing increases the irregularity in sinus arrhythmia.

  6. A rapid regular pulse, persisting under rest treatment, indicates paroxysmal tachycardia or auricular flutter.

  7. If the jugular are compared with the radial pulsations, the jugular pulsations will be found absent in fibrillation and more rapid in heart block.

  8. If the pulse is compressed with the cuff of a sphygmomanometer, a pulse deficit will be increased in

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