Atypical dicrotic notch in arterial blood pressure waveform morphology

Invasive arterial blood pressure (ABP) monitoring is an effective tool to monitor a patient's hemodynamic status and may sometimes provide valuable information about their fluid status. In the cardiac cycle, the dicrotic notch of the ABP waveform indicates closure of the aortic valve, and its location varies according to the timing of aortic closure. In normal ABP waveforms, the dicrotic notch is positioned above the morphologic level, which marks diastolic pressure (Fig. 1A). In an atypical waveform morphology occasionally discovered, the dicrotic notch is in a different position (Fig.

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