Informational Site NetworkInformational Site Network
Privacy
 


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Plate V Laryngeal And Tracheal Stenoses:

1, Indirect view, sitting position; postdiphtheric cicatricia...

Alkalies

Anything which tends to increase the acidity of the tissues a...

Back Failures

Often a severe pain in the toe, foot, ankle, or lower leg has ...

How To Get And Keep A Good Figure

Erect Position is the Result of Vigorous Health. Naturally an...

Arsenicum

acts favorably on cancers, and is a specific when applied to ...

Children's Deformed Feet

See Club Foot. ...

Depression

This is usually a bodily illness, though often regarded as men...

Of Whitlow

The lunar caustic is very useful in the treatment of this pai...

Artistic Considerations

ALTHOUGH so much time and care are given to the vario...

Hooks

No hook greater than a right angle should be used through en...

Vocal Results

A whispering voice can always be had as long as air can pass...

Highly Inflamed Throat Croup

If the _throat_ is in a highly inflamed condition, repeated p...

Unethical Illness

I see a lot of spiritually-induced physical illness in my pra...

Aphorisms

Educate your eye and your fingers. Be sure you are right...

Dysentery

This is an affection of the bowels of the nature of diarrhoea,...

Rules For The Application Of Water In Typhoid Cases

As a general rule, in typhoid cases, bathing should form one ...

Hives

See Rash. ...

Blood Pressure In Children

May Michael, [Footnote: Michael, May: A Study of Blood Pressu...

Demonstrations Of The Origin And Progress Of Inguinal Herniae In General

PLATE 41, Fig. 1.--When the serous spermatic tube is oblitera...

Tapeworm

The only sure sign of the presence of this parasite in the int...



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 del.icio.us Add to Reddit Add to Digg Add to Del.icio.us Add to Google Add to Twitter Add to Stumble Upon
Add to Informational Site Network
Report
Privacy
SHAREADD TO EBOOK


Viewed 1739