Pulsus bisferiens

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In medicine, pulsus bisferiens, also bisferious pulse or biphasic pulse, is a sign where, on palpation of the pulse, a double peak per cardiac cycle can be appreciated. Bisferious means striking twice. Classically, it is detected when aortic insufficiency exists in association with aortic stenosis, but may also be found in isolated but severe aortic insufficiency, and hypertrophic obstructive cardiomyopathy.

Normally arterial pulses are best felt in central arteries like brachial and carotid, but pulsus bisferiens is an exception to that and can be better felt in peripheral arteries like the radial artery. Another such pulse which can be felt better in peripheral arteries is pulsus alterans. The first lift is due to "percussion wave"(P) and the second lift is due to tidal wave (T).