How do you demonstrate Pulsus alternans?

How do you demonstrate Pulsus alternans?

Next use a blood pressure cuff to confirm the finding: Inflate the blood pressure cuff past systolic pressure and then slowly lower cuff pressure towards the systolic level. If alternating loud & soft Korotkoff sounds are heard, pulsus alternans is indicated.

What is a Pulsus alternans?

Pulsus alternans is an arterial pulse with alternating strong and weak beats. It is found in the setting of severe ventricular dysfunction and other forms of cardiac pathology.

How do you record pulsus paradoxus?

Technique

1. Inflate the bladder quickly to 20 mmHg above the pressure at which radial pulse is blocked.
2. Deflate the bladder 3 mmHg/sec, record the pressure at which the first Korotkoff sound is heard as the systolic pressure.
3. Continue deflating, record the disappearance of Korotkoff sounds as the diastolic pressure.

Why is Pulsus alternans in LVF?

Pulsus alternans (during pulse palpation, this is the alternation of one strong and one weak beat without a change in the cycle length) occurs most commonly in heart failure due to increased resistance to LV ejection, as occurs in hypertension, aortic stenosis, coronary atherosclerosis, and dilated cardiomyopathy.

What does electrical alternans indicate?

Electrical alternans is defined as alternating QRS amplitudes in any or all leads on an electrocardiogram (ECG) with no additional evident changes in conduction pathways of the heart. This rhythm is typically associated with pericardial effusion from fluid surrounding the heart.

What is a pulsus paradoxus?

Pulsus paradoxus is defined as a fall of systolic blood pressure of >10 mmHg during the inspiratory phase.

What is the paradox in pulsus paradoxus?

The paradox in pulsus paradoxus is that, on physical examination, one can detect beats on cardiac auscultation during inspiration that cannot be palpated at the radial pulse.