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November 1953

AORTIC ARCH SYNDROMES: Diminished or Absent Pulses in Arteries Arising from Arch of Aorta

Author Affiliations


From the Department of Medicine, Johns Hopkins University School of Medicine, Instructors in Medicine (Drs Ross and McKusick), and Johns Hopkins Hospital, Resident Physician (Dr. Ross) and Physician (Dr. McKusick).

AMA Arch Intern Med. 1953;92(5):701-740. doi:10.1001/archinte.1953.00240230101011

IN THE case of absent or diminished pulses in the arms and neck the clinician is presented with a most dramatic physical finding. Although the observation itself is elemental, the interpretation may be difficult.

Anisosphygmia, "pulsus incongruens," and "pulsus differens"1 are terms which have been applied to pulse abnormalities of this general type. "Pulseless disease" is another name applied to some of these abnormalities.2 Fortunately no eponyms have come into particular usage in connection with these cases, although the type of disease due apparently to arteritis is called Takayasu's disease in Japan.2b

It is our purpose to present cases in which the seat of the disorder is near the origin of the great vessels from the arch of the aorta. Included are various combinations of stenosis and obliteration of various branches of the aortic arch resulting from various causes. This general clinical picture may be referred to,

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