Pulsus alternans is a rare hemodynamic condition characterized by beat-to-beat variability in systolic pressure. It is attributed to variations in stroke volume with alternate cardiac cycles and is typically seen in patients with advanced myopathic conditions. Left ventricular pulsus alternans is rare, and right ventricular pulsus alternans is even less common. There are only a few reports of biventricular pulsus alternans. We report the case of a 62-year-old female with a recent anterior wall myocardial infarction who had biventricular pulsus alternans at the time of cardiac catheterization.
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http://dx.doi.org/10.4061/2009/703793 | DOI Listing |
Catheter Cardiovasc Interv
January 2025
Department of Cardiology, Başakşehir Pine and Sakura City Hospital, Istanbul, Turkey.
Pulsus alternans describes an arterial pulse waveform that shows alternating strong and weak beats despite a regular rhythm. Either discovered during physical examination or catheterization, pulsus alternans indicates severe left ventricular (LV) dysfunction and poor prognosis. There has been considerable debate about the underlying mechanism.
View Article and Find Full Text PDFCureus
October 2024
Cardiology, Beaumont Hospital, Royal Oak, USA.
JACC Case Rep
October 2024
Department of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
A 58-year-old man presented with worsening dyspnea. Electrocardiogram showed variation in T-wave amplitude occurring every other beat. Transthoracic echocardiography revealed a severe aortic stenosis with beat-to-beat variation in stroke volume, suggestive of pulsus alternans.
View Article and Find Full Text PDFEur Heart J
September 2024
Department of Cardiovascular Medicine, Niigata University Medical and Dental Hospital, 1-754 Asahimachidori, Chuoku, Niigata 951-8520, Japan.
Eur Heart J Case Rep
January 2024
Department of Cardiovascular Medicine, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata-city 951-8520, Japan.
Background: Pulsus alternans has been considered a sign of poor prognosis in patients undergoing treatments for heart failure. However, it may be overlooked in patients with intra-aortic balloon pumps (IABPs). The use of IABP and ivabradine for a β-blocker introduction in a patient with dilated cardiomyopathy (DCM) and pulsus alternans and its consequence have never been reported.
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