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19 Possible Causes for Changing Cardiac Murmurs, Pulsus Alternans

  • Congestive Heart Failure

    alternans (alternating large and small pulse pressures) and a raised JVP.[] alternans Increased intensity of P 2 heart sound Hepatojugular reflux Ascites, hepatomegaly, and/or anasarca Central or peripheral cyanosis, pallor See Presentation for more[] Signs There may be a tachycardia at rest, low systolic blood pressure (BP), a displaced apex (LV dilatation) or RV heave (pulmonary hypertension), a narrow pulse pressure or pulsus[]

  • Cardiomyopathy

    RATIONALE: Left ventricular non-compaction cardiomyopathy (LVNC) is a rare heart disorder related to thrombosis. Anticoagulant therapy is suggested for the treatment of this disease. The success of the novel oral anticoagulant rivaroxaban as a treatment option for this disorder is unclear. PATIENT CONCERNS: A[…][]

  • Myocardial Infarction

    Coronary Heart Disease A heart attack happens if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked and the heart can't get oxygen. Most heart attacks occur as a result of coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque builds up inside[…][]

  • Acute Myocardial Infarction

    Ventricular septal rupture (VSR) is a rare but fatal complication of acute myocardial infarction (AMI) with an associated mortality that ranges from 41% to 80%. The treatment consists of supplemental oxygenation, afterload reduction, intraaortic balloon pump, and surgical repair. In selected patients, extracorporeal[…][]

  • Acute Myocarditis

    Abstract A 5-month-old boy was admitted to hospital presenting with cardiogenic shock. The echocardiographic examinations revealed a severe ventricular dysfunction. Despite the aggressive medical therapy, his hemodynamic status progressively deteriorated. Mechanical circulatory support was initially provided with[…][]

  • Hypersensitivity Myocarditis

    A rare, but frequently fatal, side effect of the antipsychotic drug clozapine is myocarditis. We report a case of hypersensitivity myocarditis secondary to clozapine administration that was diagnosed in vivo for the first time through endomyocardial biopsy and was successfully treated with corticosteroids. Histologic[…][]

  • Rheumatic Heart Disease

    Sydenham's chorea is the most common type of acquired chorea in childhood which is a major neurological manifestation of rheumatic fever. We describe a 13 years old girl who presented with weakness and purposeless involuntary movements of upper and lower limbs. The symptoms slightly affected the child's daily[…][]

  • Acute Aortic Regurgitation

    Signs of the disease commonly include tachycardia, cyanosis, pulsus alternans, crepitations in the lungs indicating pulmonary edema and hypotension and peripheral vasoconstriction[] The figure at the right shows the changes in aortic pressure (AP), left ventricular pressure (LVP) and left atrial pressure (LAP) that can be observed during the cardiac cycle[] The backward flow of blood into the ventricular chamber during diastole results in a diastolic murmur.[]

  • Libman-Sacks Disease

    The following signs of ventricular enlargement and cardiac failure might be noted: Tachypnea and cyanosis Pulse (plateau pulse, low-volume pulse, pulsus alternans) Jugular[]

  • Aortic Valve Stenosis

    Pulsus alternans can occur in the presence of LV systolic dysfunction.[] […] at the access site; exercise intolerance or weakness; inflammation; angina; heart murmur; and fever.[] Other symptoms of aortic stenosis include the following: Pulsus alternans: Can occur in the presence of left ventricular systolic dysfunction Hyperdynamic left ventricle:[]

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