The joke maker's association had a feast. They exploited their humorous abilities, and all made merry, save one glum guest. At last, they insisted that this melancholy person should contribute to the entertainment. He consented, in response to ... Read more of Jokes at Free Jokes.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Strychnine

Emetic; keep quiet and darken the room. Chloral or bromide of ...

The Form Of The Thoracic Cavity And The Position Of The Lungs Heart And Larger Bloodvessels

In the human body there does not exist any such space as cavi...

Catarrh Acute

If in the head, treat as prescribed for common colds in the h...

Fright

Some most distressing troubles come as the result of frights. ...

The Vegetable Kingdom

As to the vegetable kingdom, there is here, so far as we can ...

Bruises

For slight bruises, such as children frequently get by falling...

Papillomata

Decannulation after tracheotomy done for papillomata should ...

Stage 4 Passing Through The Hiatus Esophageus

When the head is dropped, it must at the same time be moved ...

Children's Nerves

The nervous system of children is often damaged by shock or fr...

Polar Antagonism

When the conducting cords are of equal length, as commonly th...

Weight Loss By Fasting

Loss of weight indicates, almost guarantees, that detoxificat...

Illustrations

I shall give a couple of illustrations: In the winter of 1...

Alcohol

How Alcohol is Made. The most dangerous addition that man has...

Tuberculosis Of The Esophagus

Esophageal tuberculosis is not commonly met, but is probably ...

Heart Disease In Children And During Pregnancy

A common characteristic in a large proportion of middle-age...

Auricular Fibrillation Auricular Flutter

Auricular fibrillation is at times apparently a clinical enti...

Liver The

Where biliousness prevails, without any symptom of real liver ...

Division Of The Process Of The Disease Into Periods

Its course is commonly divided into four distinct periods, vi...

Small Pox - Variola

This disease begins with pain in the head and back, chilly se...

More Facts!

I have been treating several hundred cases of eruptive fevers...



Pulsus Alternans





Category: Uncategorized
Source: Disturbances Of The Heart

By this term is meant that condition of pulse in which, though the
rhythm is normal, strong and weak pulsations alternate. White
[Footnote: White: Am. Jour. Med. Sc., July, 1915, p. 82.] has shown
that this condition is not infrequent, as demonstrated by
polygraphic tracings. He found such a condition present In seventy-
one out of 300 patients examined, and he believes that if every
decompensating heart with arrhythmia was graphically examined, this
condition would be frequently found. The alternation may be
constant, or it may occur in phases. It is due to a diminished
contractile power of the heart when the heart muscle has become
weakened and a more or less rapid heart action is present.

Gordinier [Footnote: Gordinier: Am. Jour. Med. Sc., February, 1915,
p. 174.] finds that most of these patients with alternating pulse
are suffering from general arteriosclerosis, hypertension, chronic
myocarditis, and chronic nephritis, in other words, with
cardiovascularrenal disease. He finds that it frequently occurs with
Cheyne-Stokes respiration, and continues until death. He also finds
that the condition is not uncommon in dilated hearts, especially in
mitral disease, and with other symptoms of decompensation.

White found that about half of his cases of pulsus alternans showed
an increased blood pressure of 160 mm. or more; 62 percent. were in
patients over 50 years of age, and 69 percent. were in men.
Necropsics on patients who died of this condition showed coronary
sclerosis and arteriosclerotic kidneys.

The onset of dyspnea, with a rapid pulse, should lead one to suspect
pulsus alternans when such a condition occurs in a person over 50
with cardiovascular-renal disease, arid with signs of
decompensation, and also when such a condition occurs with a patient
who has a history of angina pectoris.

While the forcefulness of the varying beats of an alternating pulse
may be measured by blood pressure instruments by the auscultatory
method, White and Lunt [Footnote: White, P. D. and Lunt, L. K.: The
Detection of Pulsus Alternans, THE JOURNAL A. M. A., April 29, 1916,
p. 1383.] find that in only about 30 percent. of the cases, the
graver types of the condition, is this a practical procedure.

Pulsus alternans, except when it is very temporary, Gordinier finds
to be of grave import, as it shows myocardial degeneration, and most
patients will die from cardiac insufficiency in less than three
years from the onset of the disturbance.

The treatment is rest in bed and digitalis, but White found that in
only four patients out of fifty-three so treated was the alternating
pulse either "diminished or banished." In a word, the only treatment
is that of decompensation and a dilated heart, and when such a
condition occurs and is not immediately improved, the prognosis is
bad, under any treatment.





Next: Bradycardia

Previous: Auricular Fibrillation Treatment



Add to Informational Site Network
Report
Privacy
ADD TO EBOOK


Viewed 2439