Fig. 2. The parvus (low amplitude) and tardus (slow uprising, arrow) pulse of severe calcified aortic stenosis. The irregularity in the slowly uprising pulse is from the turbulence created by the stenotic aortic valve and, on palpation, is often felt as a shudder (s) in the carotid pulse. Note that the degree to which a pulse is parvus and tardus correlates with the severity of aortic stenosis. S1, first heart sound; S2, second heart sound.