Informational Site NetworkInformational Site Network
Privacy
 


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Chloroform Or Ether (inhaled)

Fresh air. Pull tongue forward, and begin artificial respirati...

Habit And Nervous Strain

PEOPLE form habits which cause nervous strain. When t...

The Throat Should Be Covered With A Wet Compress I E A Piece Of

linen four to eightfold, according to its original thickness, d...

The Need Of Pure Air

Free Air is Pure. As air, in the form of wind, actually sweep...

Blood

A most common trouble is anaemia, a lack of good red blood, sh...

Why Does Mrs Smith Get On My Nerves?

IF you want to know the true answer to this question ...

Direct Laryngoscopy In Diseases Of The Larynx

The diagnosis of laryngeal disease in young children, impossi...

Eyes Inflamed With General Eruptions Over The Body

In some cases the eye trouble is only a part of a general skin...

Fever Intermitting

For this the treatment may be given as in gastric fever, and, ...

Mammary Abscess

(_Ague in the breast--Inflamed breast_.) This is a disease...

Anesthesia

No dyspneic patient should be given a general anesthetic; be...

Auricular Fibrillation Prognosis

The prognosis depends on the condition of the myocardium of t...

From The Hygienic Dictionary

Vitamins. [1] The staple foods may not contain the same nutr...

Talismans

A talisman may be described as an emblematical object or im...

Diet Economy In

Dr. Hutchison, one of our greatest authorities on the subject ...

The Ammonium Carbonicum

recommended by Peart, has been considered by many as a specif...

Treating With Electrolytic Currents

For decomposing and carrying off unnatural growths, as fistul...

Mouth-gag

Wide gagging prevents proper exposure of the larynx by forci...

Ankylosis

Fixation of the crico-arytenoid joints with an approximation...

Tuberculosis Of The Esophagus

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



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 1174