How do you assess pulsus alternans?

How do you assess pulsus alternans?

Pulsus alternans can be identified by palpating the artery, using a sphygmomanometer, and examining arterial and plethysmographic waveforms. [12] Pulsus alternans becomes difficult to assess by the palpatory method when there is a greater than 20 mmHg difference between large and small systolic beats.

Does pericardial effusion show electrical alternans?

Electrical alternans, although considered pathognomonic for pericardial effusion, is not a diagnostic factor for effusion and cardiac tamponade as other pathologies can result in this ECG finding.

Why are there pulsus alternans in heart failure?

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 pulsus alternans indicate?

Pulsus alternans indicate cardiac pathology, particularly left ventricular dysfunction, and is considered a poor prognostic indicator. When identified, pulsus alternans should elicit prompt treatment of the underlying causative process.

What is the difference between pulsus alternans and pulsus paradoxus?

Pulsus alternans is a pulse pattern in which there is alternating (beat-to-beat) variability of pulse strength due to decreased ventricular performance. This is sometimes seen in patients with severe CHF. Pulsus paradoxus indicates an exaggeration of the normal reduction of systolic blood pressure during inspiration.

What are the ECG changes in pericardial effusion?

Background: The ECG changes associated with pericardial effusion described in textbooks are based only on small series of human cases and data from animals. These changes include low QRS voltage, electrical alternans, P wave changes, and T wave inversion.

Why do you get Pulsus Paradoxus in cardiac tamponade?

Some heart conditions can also cause pulsus paradoxus, such as: Cardiac tamponade. This condition happens when fluids build up in the sac around your heart called the pericardium, compressing your heart. This causes your blood flow to drop, leading to a fall in blood pressure.

Why do you get pulsus paradoxus in cardiac tamponade?