Pulsus Alternans: Causes & Reasons

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Possible Causes for Pulsus Alternans

Alcoholic Cardiomyopathy

Leg elevation promptly reversed the pulsus alternans, and the echocardiographic abnormality. [ncbi.nlm.nih.gov]

Application of a small dose of glyceryl trinitrate paste (0.25 in) resulted in severe left ventricular dysfunction with the appearance of pulsus alternans in a patient with [ncbi.nlm.nih.gov]

Dilated Cardiomyopathy

Pulsus alternans is an infrequent, complex pathophysiologic sign often associated with severe heart failure. [ncbi.nlm.nih.gov]

Evaluation noted pulsus alternans, with beat-to-beat alternations in aortic pulse wave amplitude, both clinically and on diagnostic studies. [ncbi.nlm.nih.gov]

Recognition of pulsus alternans is important as it provides significant clinical information, may suggest suboptimal medical management, and may be the first warning sign [ncbi.nlm.nih.gov]

Fungal Myocarditis

Once heart dysfunction sets in, signs of cardiac failure may manifest, such as pulmonary edema (fluid accumulation in the lungs), peripheral oedema, hypoxemia, pulsus alternans [medindia.net]

Congestive Heart Failure

alternans (alternating large and small pulse pressures) and a raised JVP. [patient.info]

[…] shock: - pulmonaal: tachypnee, cyanose, longoedeem, cheyne- stokes ademhaling, sputum - cardiaal: gecombineerd met myocardischaemie of AMI, tachycardie, milde hypotensie, pulsus [medics4medics.com]

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 [patient.info]

Heart Failure

alternans (alternating large and small pulse pressures) and a raised JVP. [patient.info]

Pulsus alternans is usually associated with an S 3 gallop, signifies advanced myocardial disease, and often disappears with treatment of heart failure. [emedicine.medscape.com]

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 [patient.info]

Pulmonary Edema

alternans or presence of valvular heart disease 발생기전 혈관내 용질과 액체가 간질로 빠져나가서 발생 4가지 기전 정수압의 상승 Starling equation Q(iv-int) = Kf[(Piv - Pint) - Summationf(∏iv - ∏int)] Q = net [clinicclinic2.cafe24.com]

[…] retraction of the intercostal spaces or supraventricular fossae Cheyne-Stokes respirations 심혈관계 증상 빈맥 Jugular venous hypertension 비정상적인 심음 P2 심음의 증가 S3 S4 Nocturnal angina Pulsus [clinicclinic2.cafe24.com]

Cardiomyopathy

ESC Heart Fail. 2018 Feb;5(1):197-200. doi: 10.1002/ehf2.12242. Epub 2018 Jan 13. Author information 1 Echocardiography Laboratory, Division of Pediatric Cardiology and Arrhythmology, Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children Hospital-IRCSS, Rome, Italy. 2 Division of Cardiac[…] [ncbi.nlm.nih.gov]

Myocardial Infarction

Myocardial infarction, commonly referred to as heart attack, is a condition characterized by necrosis of the heart muscles due to development of ischemia that stays on for prolonged periods. Such a condition develops when the heart does not receive oxygen and blood due to blockage in the coronary arteries.[…] [symptoma.com]

Acute Myocardial Infarction

We herein report the case of a 25-year-old Japanese woman with left-main-trunk acute myocardial infarction (LMT-AMI). She had cardiogenic shock, so emergency percutaneous intervention was performed. Intravascular ultrasound of LMT-AMI showed that the three-layered structure of the intima, tunica media, and[…] [ncbi.nlm.nih.gov]

Ischemic Cardiomyopathy

Because of the shortage of donor hearts, 16 (33%) of 48 patients with ischemic cardiomyopathy died awaiting transplantation. Determining factors that predict effective coronary revascularization and identifying patients who may benefit from revascularization is crucial. From 1984 to 1990, 207 ischemic cardiomyopathy[…] [ncbi.nlm.nih.gov]

Acute Myocarditis

AIM: Cardiac magnetic resonance (CMR) can visualize inflammatory tissue changes in acute myocarditis. Several quantitative image-derived parameters have been described to enhance the diagnostic value of CMR, but no direct comparison of these techniques is available. METHODS AND RESULTS: A total of 34 patients with[…] [ncbi.nlm.nih.gov]

Primary Cardiomyopathy

From Systematic Investigation and Research on Interventions and Outcomes (SIRIO) MEDICINE Research Network, Collegium Medicum in Bydgoszcz, Dr Antoni Jurasz Memorial University Hospital, and Nicolaus Copernicus University, Bydgoszcz, Poland; University of Nicolaus Copernicus, Toruń, Poland; Catholic University, Rome,[…] [annals.org]

Toxic Myocarditis

The clinical manifestation and natural history of myocarditis range is variable from asymptomatic stages to intractable circulatory compromise and death. Supportive therapy is paramount in the treatment of this condition. The use of mechanical circulatory support as bridge-to-recovery or bridge-to-transplantation[…] [ncbi.nlm.nih.gov]

Lymphocytic Myocarditis

This study reports the development of lymphocytic myocarditis in a bilateral lung allograft recipient. A 23-year-old woman developed congestive heart failure and severe left ventricular dysfunction 32 months after a bilateral lung allograft for cystic fibrosis. She had taken oral acyclovir for infectious mononucleosis[…] [ncbi.nlm.nih.gov]

Myocardial Fibrosis

Pediatr Cardiol. 2018 Jan;39(1):105-110. doi: 10.1007/s00246-017-1734-2. Epub 2017 Sep 25. Author information 1 Department of Radiology, Cairo University Hospitals, Cairo, Egypt. Ahmedkharabish@hotmail.com. 2 Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum München, Technische[…] [ncbi.nlm.nih.gov]

Hypersensitivity Myocarditis

Eosinophilic myocarditis is an inflammatory condition of the heart in which the infiltrate is composed predominately of eosinophils. We identified three cases of eosinophilic myocarditis in which the infiltrating eosinophils showed a remarkable intimate association with bundles of collagen. Two of the hearts examined were[…] [ncbi.nlm.nih.gov]

Giant Cell Myocarditis

Am J Cardiol. 2008 Dec 1;102(11):1535-9. doi: 10.1016/j.amjcard.2008.07.041. Epub 2008 Sep 18. Cooper LT Jr 1, Hare JM, Tazelaar HD, Edwards WD, Starling RC, Deng MC, Menon S, Mullen GM, Jaski B, Bailey KR, Cunningham MW, Dec GW ; Giant Cell Myocarditis Treatment Trial Investigators. Collaborators (23) Cooper LT Jr, Menon S,[…] [ncbi.nlm.nih.gov]

Viral Myocarditis

AIMS: Viral myocarditis (VM) is an important cause of heart failure and sudden cardiac death in young healthy adults; it is also an aetiological precursor of dilated cardiomyopathy. We explored the role of the miR-221/-222 family that is up-regulated in VM. METHODS AND RESULTS: Here, we show that microRNA-221[…] [ncbi.nlm.nih.gov]

Bacterial Myocarditis

A 69-year-old woman without any past disease history was hospitalized for heart failure. After hospitalization, she showed myocardial infarction, atrioventricular dissociation, and cardiac dysfunction, and finally she passed away despite intensive care. Autopsy revealed that the cardiac abnormalities were due to[…] [ncbi.nlm.nih.gov]

Rheumatic Heart Disease

BMC Res Notes. 2018 Apr 3;11(1):221. doi: 10.1186/s13104-018-3341-6. Author information 1 Buea Regional Hospital, Buea, South West Region, Cameroon. cnkoke@yahoo.com. 2 Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, Cameroon. cnkoke@yahoo.com. 3 Faculty of Medicine and Biomedical Sciences,[…] [ncbi.nlm.nih.gov]

Secondary Cardiomyopathy

S Glackin 1,2, P Mayne 2,3, D Kenny 4, CJ McMahon 4, D Cody 1 1 Department of Endocrinology, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland 2 Children's University Hospital, Temple St, Dublin 1, Ireland 3 Department of Biochemistry, Our Lady’s Children’s Hospital, Crumlin, Dublin 12, Ireland 4 Department of[…] [imj.ie]

Hemochromatosis-Related Cardiomyopathy

The hallmark of hemochromatosis is the deposition of iron in multiple tissue types, most notably the skin, liver, pancreas, thyroid, and heart. Definitive diagnosis of iron deposition generally requires invasive methods, such as direct tissue biopsy. We describe a 40 year-old woman with end-stage liver disease secondary[…] [ncbi.nlm.nih.gov]

Chronic Right-Sided Congestive Heart Failure

alternans, (alternating pulses, strong weak), Increased heart rate, PMI displaced inferiorly and posteriorly. [quizlet.com]

alternans 1,2 right-predominant symptoms and signs nocturia 1,2 sacral and scrotal edema, especially if bed bound 1,2 peripheral (ankle) edema 1,2 ascites 1,2 hepatomegaly [radiopaedia.org]

alternans May present as a sign of advanced ventricular dysfunction Right-sided heart failure Symptoms Peripheral edema, sacral edema, ascites and/or anasarca Various manifestations [pathophys.org]

Bidirectional Tachycardia

Pulsus alternans. [ahajournals.org]

Intra-arterial hemodynamic monitoring during the arrhythmia displayed pulsus alternans (Figure 2). Figure 1. Bidirectional ventricular tachycardia. [ahajournals.org]

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 [symptoma.com]

Physical Examination – Acute AR • Tachycardia • Peripheral vasoconstriction • Cyanosis • Pulmonary edema • Arterial pulsus alternans; normal LV impulse • Early mitral valve [slideshare.net]

Pulsus Bisferiens

Pulsus alternans is usually associated with an S 3 gallop, signifies advanced myocardial disease, and often disappears with treatment of heart failure. [medscape.com]

pulsus — SYN: pulse. [deacademic.com]

Pulsus alternans From Wikipedia the free encyclopedia Jump to navigation search Not be confused with paradoxus [...] [i2mmarketing.com]

Hydropericardium

Sometimes, large pericardial effusions may exhibit electrical alternation of QRRS voltage or "pulsus alternans" reflecting free swing of the heart within the pericardial fluid [emedicine.medscape.com]

Suppurative Pericarditis

alternans 交互脈 pulsus paradoxus 奇脈 pupillary reaction 瞳孔反応 pure gonadal dysgenesis 純型性腺形成不全 pure red cell aplasia 赤芽球癆 PRCA purified protein derivative 精製ツベルクリン PPD purine [jpeds.or.jp]

[…] pulmonary venous hypertension 肺静脈圧上昇 pulp pinch 指腹つまみ pulsatile secretion 拍動性分泌 pulsation 拍動 pulse 脈 pulse pressure 脈圧 pulse rate 脈拍数 pulse therapy パルス療法 pulseless disease 脈なし病 pulsus [jpeds.or.jp]

Presbycardia

H & P- 4 most reliable signs of CHF: 1) pulsus alternans, 2) reduced proportional pulse pressure ([SBP-DBP]/SBP < 0.25), 3) abnormal BP response to Valsalva, 4) JVD. [lartsai.com]

Chronic Pulmonary Edema