Pulsus bisferiens

Pulsus bisferiens or double pulse refers to a wave pattern where there is the presence of two systolic peaks that can be seen in pressure tracings of the the ascending aorta, the aortic arch, and the carotid artery.

It can occur in patients with

• aortic valve pathology: aortic regurgitation with or without concurrent aortic stenosis
• severe obstructive hypertrophic cardiomyopathy. 
• aortic dissection: rare