Difference in Blood Pressure or Pulse Between Both Arms

CLINICAL DIAGNOSTIC MANUAL

A difference in blood pressure or pulse between both arms is a condition where a significant discrepancy is observed in the measurements of blood pressure or pulse palpation between the right and left arms.

This difference may indicate various vascular and structural pathologies affecting blood circulation in the arms. Detecting and understanding the underlying cause of this discrepancy is essential for the accurate diagnosis and treatment of associated medical conditions.

Pathology	Suspected Diagnosis	Confirmatory Diagnosis
Atheromatous arterial thrombosis	Difference in blood pressure, intermittent claudication, coldness in the affected arm.	Arterial Doppler ultrasound, angiography.
Ascending aortic dissection	Acute chest pain, difference in blood pressure, dizziness, syncope.	Thoracic CT or MRI, echocardiogram.
Supravalvular aortic stenosis	Heart murmur, differential hypertension, fatigue, dyspnoea.	Echocardiogram, angiography.
Subclavian steal syndrome	Difference in blood pressure, dizziness, syncope, arm claudication.	Arterial Doppler ultrasound, angiography.
Thoracic outlet syndrome	Pain and paraesthesia in the affected arm, difference in blood pressure, weakness.	Thoracic MRI or CT, electromyography (EMG).
Aortic arch syndrome	Difference in blood pressure, diminished pulse, symptoms of vascular insufficiency.	Angiography, echocardiogram, CT or MRI.
Takayasu’s arteritis	Diminished pulse in one or both arms, difference in blood pressure, fever, weight loss.	Angiography, blood tests (inflammatory markers), MRI of arteries.