Brachioradial delay: a new clinical indicator of the severity of aortic stenosis.

During the assessment of patients with severe or symptomatic aortic stenosis, a clinically detectable delay between the brachial and radial pulses was observed. This delay was not present in normal subjects. The timed delay of 53.5 (SE 2.6) ms in severe aortic stenosis was significantly longer than that in normal volunteers 22.6 [1.3] ms) or in patients with low cardiac output. This increased delay was clinically detectable before the occurrence of left ventricular failure and often before the onset of symptoms.