Informational Site NetworkInformational Site Network
Privacy
 


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Locomotor Ataxia

This disease is a most difficult one to deal with, and any hea...

Necessity Of Ventilation Means Of Heating The Sick-room Relative Merits Of Open Fires Stoves And Furnaces

Next to its intrinsic value, our method gives the patient the...

Scarlatina Miliaris

Sometimes the red patches of the rash are covered with small ...

From The Hygienic Dictionary

Doctors. [1] In the matter of disease and healing, the peopl...

Dimensions Of The Trachea And Bronchi

It will be noted that the bronchi divide monopodially, not d...

Diet For A Healthy Person

I doubt that it is possible to be totally healthy in the twen...

Haemorrhage

See Bleeding; Wounds. ...

Lungs Bleeding From

This is usually taken as a most alarming, and even hopeless, s...

Baths And Bathing

Bathing as a Means of Cleanliness. It has been said that one ...

Stone

See Gravel. ...

Erysipelas

This is a disease of the skin, producing redness, burning and...

Shock

The treatment of shock will probably always be unsatisfactory...

Safety-pin Closer

There are a number of methods for the endoscopic removal of ...

During And After Desquamation The Treatment Should Be Continued As

indicated in milder cases, except the throat continue troubleso...

Asthma

If an attack comes on from sudden cold, take _Aconite_ and _I...

Sprains Or Racks

A sprain is usually the result of some involuntary stress comi...

Mushrooms

Emetic; castor oil and enema. ...

Limbs Drawn-up

We have had many cases of contracted limbs, arising from vario...

The Surgical Dissection Of The Superficial Bloodvessels Etc Of The Inguino-femoral Region

Hernial protrusions are very liable to occur at the inguino-f...

Length Of Pack Perspiration

To make quite sure of the reaction, the single sheet may be t...



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 1278