Dr.S.Venkatesan MD

Learned physicians will agree, BP recording by classical auscultatory   method  is  not always an  easy task !

Such an important clinical sign is left to the whims and fancies of human ear’s ability to detect  of low pitched vibrations emanating from deep seated brachial artery .(5 phases of Korotkoff )

Since  Korotkoff sounds are low frequency sounds , it is best heard with bell of the stethoscope ? How many of us do it ?

There is little surprise , two BP  recordings  rarely  match even if it’s performed minutes  apart  !

While phase one is easily identified , the gap between phase 4 and 5 can be very  narrow and  differentiating  them is often an auditory illusion.

Korotkoff sounds is  subjected to severe tissue plane damping esepcailly in low flow states and obese arms.

So is there an alternative  method to measure diastolic BP ?

Most will agree , systolic BP can be  well measured by palpation ,

What about diastolic BP ?

In this technological era , it may appear foolish to depend on a tactile measurement . But as these articles suggest , it is worth a try!

In certain population  we know the kortokoff sounds are low quality .Auditory interference can be more than tactile sensation. In those hands ,Korotokoff  equivalents  can be felt by sensitive fingers.

After thought

How does automated BP recorders  sense systolic and  diastolic BP ?

Does it sense the sound or feel the vibrations.

Reference