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May 22,  · Other possible causes of a double apical pulse include: high blood pressure; then multiply the total by two to determine the heart rate per minute. Apical-radial pulse deficit.

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However, at this time, blood pressure could still only be measured by invasive means. The race was now on to find a suitable way to measure blood pressure non-invasively. In , Karl Vierordt discovered that with enough pressure the arterial pulse could be obliterated. Vierordt introduced the sphygmograph, based on this principle of obliteration.