Pulsus alternans
| Pulsus alternans | |
|---|---|
| Other names | Cardiac alternans, mechanical alternans |
 | |
| Pulse pressure waveform displaying the variation in pressure between beats in pulsus alternans. | |
| Specialty | Cardiology |
Pulsus alternans is a physical finding with arterial pulse waveform showing alternating strong and weak beats.[1] It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis.
The condition is relatively rare, and patients with the greatest risk for developing pulsus alternans include those with heart failure, cardiomyopathy, coronary artery disease, or other cardiac risk factors.[2]
Pathophysiology
One explanation is that in left ventricular dysfunction, the
Diagnosis
Pulsus alternans is diagnosed by first palpating the radial or femoral arteries, feeling for a regular rhythm but alternating strong and weak pulses. Next, a blood pressure cuff is used to confirm the finding: the cuff is elevated past systolic pressure and then slowly lowered cuff towards the systolic level. If alternating loud and soft Korotkoff sounds are heard, pulsus alternans is indicated.[3]
Clinical significance
A finding of pulsus alternans is indicative of severe left-sided heart failure. [4]
In literature
Then he felt her pulse. There was a strong stroke and a weak one, like a sound and its echo. That was supposed to betoken the end....
References
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