Friday, 30 May 2014

Pulsus alternans

Pulsus alternans, in contrast, is defined by beat-to-beat variability of pulse amplitude. It is present only when every other phase I Korotkoff sound is audible as the cuff pressure is lowered slowly, typically in a patient with a regular heart rhythm and independent of the respiratory cycle. In patients with normal heart rates, the finding of pulsus alternans indicates severe left ventricular dysfunction, caused by ischemic or valvular heart disease, long-standing hypertension, or idiopathic dilated cardiomyopathy. In patients with rapid heart rates, Pulsus alternans is of less significance as people with normal heart can develop the finding during paroxysmal tachycardia.
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