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Right-sided pulsus alternans in diastolic left ventricular dysfunction.

R Ilia1, A Abu-Ful, J M Weinstein

  • 1Cardiology Department, Soroka Medical Center and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|July 13, 1999
PubMed
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Pulsus alternans, typically linked to poor systolic function, was observed in a patient with preserved ventricular function. This unique case highlights alternans in the right heart chambers despite normal aortic and left ventricular function.

Area of Science:

  • Cardiology
  • Physiology
  • Hemodynamics

Background:

  • Pulsus alternans is a clinical sign characterized by regular alternation of the pulse's systolic amplitude.
  • It is commonly associated with severe left ventricular systolic dysfunction.

Observation:

  • A patient presented with dyspnea, hypertension, and left ventricular hypertrophy.
  • Despite normal left and right systolic function, pulsus alternans was detected.

Findings:

  • Pulsus alternans was evident in the pulmonary wedge pressure, pulmonary artery, and right ventricle.
  • Alternating pulse patterns were absent in the aorta and left ventricle.

Implications:

  • This case challenges the traditional association of pulsus alternans solely with left ventricular systolic impairment.

Related Experiment Videos

  • It suggests that right heart alternans can occur independently of left heart systolic dysfunction.
  • Further investigation into the mechanisms of right heart alternans is warranted.