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Normal pulse waveform will display:
(1) a rapid rise in the upstroke during systole,
(2) a very sharp peak,
(3)
a gradual downstroke,
(4) a presence of dicrotic notch.
An absence of the dicrotic notch, a smaller amplitude, decreased
slope and rounding of the systolic peak are the initial signs of a
possible abnormality - the measured ABI value is lower than the
one with normal pulse waveform.
A flattened PVR waveform or a PVR without the typical shape is an
indicator of severe PAD. The absence of the pulsations caused by
occlusions in the artery makes it impossible to calculate the ankle
pressures. Instead of ABI value, the device will display a “PAD” result,
indicating severe disease. The result is confirmed with non-typical,
flattened PVR waveform, similarly to the picture below.
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