Pulsus alternans

Pulsus alternans

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.

Pathophysiology

In left ventricular dysfunction, the ejection fraction will decrease significantly, causing reduction in stroke volume, hence causing an increase in end-diastolic volume. There may initially be a tachycardia as a compensatory mechanism to try and keep the cardiac output constant. As a result, during the next cycle of systolic phase, the myocardial muscle will be stretched more than usual and as a result cause an increase in myocardial contraction, related to the Frank-Starling physiology of the heart. This results, in turn, in a stronger systolic pulse.


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  • pulsus alternans — pul·sus al·ter·nans pəl səs ȯl tər .nanz n alternation of strong and weak beats of the arterial pulse due to alternate strong and weak ventricular contractions * * * see under pulsus …   Medical dictionary

  • pulsus alternans — alternately strong and weak pulse …   English contemporary dictionary

  • pulsus alternans — alternate variation of the force of the pulse due to variation in force of heart muscle contraction. It is a sign of cardiomyopathy and heart failure …   The new mediacal dictionary

  • alternans — Alternating; often used substantively for alternation of the heart, either electrical or mechanical. Alternating; used as a noun in the sense of pulsus a.. [L.] auditory a. SYN: auscultatory a.. auscultatory a. alternation in the intensity of… …   Medical dictionary

  • Pulsus Paradoxus — Dieser Artikel oder Abschnitt ist nicht hinreichend mit Belegen (Literatur, Webseiten oder Einzelnachweisen) versehen. Die fraglichen Angaben werden daher möglicherweise demnächst gelöscht. Hilf Wikipedia, indem du die Angaben recherchierst und… …   Deutsch Wikipedia

  • Pulsus paradoxus — In medicine, a pulsus paradoxus (PP), also paradoxic pulse and paradoxical pulse, is an exaggeration of the normal variation in the pulse during the inspiratory phase of respiration, in which the pulse becomes weaker as one inhales and stronger… …   Wikipedia

  • Pulsus bisferiens — In medicine, pulsus bisferiens, also bisferious pulse or biphasic pulse, is a sign where, on palpation of the pulse, a double peak per cardiac cycle can be appreciated. Bisferious means striking twice. Classically, it is detected when aortic… …   Wikipedia

  • alternans — n. alternating; alternation (as in pulsus alternans in Medicine) …   English contemporary dictionary

  • total alternans — pulsus alternans in which alternate beats are so weak that they are not detected, causing apparent halving of the pulse rate …   Medical dictionary

  • pulsus — SYN: pulse. [L. a stroke, pulse] p. abdominalis SYN: abdominal pulse. p. alternans SYN: alternating pulse. p. anadicrotus SYN: anacrotic pulse. p. bigeminus SYN: bigeminal pulse. p. bisferiens SYN: bisferious pulse. p. caprisans a bounding… …   Medical dictionary

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