Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats. It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. One explanation is that in left ventricular dysfunction, the ejection fraction will...
Most common diseases
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]
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 [medicsformedics.nl]
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 rate [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
SAN FRANCISCO (March 7, 2013)--New Orleans residents continue to face a three-fold increased risk of heart attack post-Katrina--a trend that has remained unchanged since the storm hit in 2005, according to research being presented at the American College of Cardiology's 62nd Annual Scientific Session. The new[…] [eurekalert.org]
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]
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]
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]
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]
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]