All about alternans
Here is all you wanted to know about alternans: Traube’s pulse, total pulsus alternans, diastolic pulsus alternans, right ventricular pulsus alternans, biventricular pulsus alternans and electrical alternans!
Traube’s pulse – pulsus alternans
Pulsus alternans or Traube’s pulse was described by Ludwig Traube in 1872 [1]. Pulsus alternans is nothing but alternating pulses having different volumes and is a feature of left ventricular dysfunction. It is well known that pulsus alternans can be augmented by a premature ventricular contraction [2].
A rare case of pulsus alternans due to 2:1 left bundle branch block (LBBB) has also been described [3]. The patient had normal coronaries and a left ventricular ejection fraction of 50%. The dyssynchrony associated with LBBB was thought to reduce left ventricular output during the block and consequent lower pulse volume in alternating beats.
Pulsus alternans with diastolic left ventricular dysfunction in the absence of systolic dysfunction was noted in a case of renal artery stenosis and pulmonary edema [4]. The pulsus alternans in this case disappeared after renal revascularization.
Treatment of heart failure causes improvement in pulsus alternans [5]. Similarly, improvement in pulsus alternans by ventilation therapy has been documented [6].
References
Conti AA. Nineteenth century “Traube’s pulse” and current “Cardiac alternans”: significant features in the history of cardiology. Clin Ter. 2012;163(2):e7...
Source: Cardiophile MD - Category: Cardiology Authors: Johnson Francis Tags: General Cardiology biventricular pulsus alternans Brody's effect diastolic pulsus alternans electrical alternans right ventricular pulsus alternans total pulsus alternans Traube's pulse Source Type: blogs
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