"Mary, the wife of John Goffe of Rochester, being afflicted with a long illness, removed to her father's house at West Mulling, about nine miles from her own. There she died on 4th June, this present year, 1691. "The day before her departur... Read more of The Dying Mother {101} at Scary Stories.caInformational Site Network Informational
Privacy


Home


Medical Articles


Mother's Remedies


Household Tips


Medicine History


Forgotten Remedies


Search

Medical Articles

Diets To Heal The Critically Ill

A critically ill person is someone who could expire at any mo...

Children And Teachers

Children are of the utmost value to society; through any one o...

Acute Stenosis Of The Larynx

Etiology.--Causes of a relatively sudden narrowing of the lum...

Diet For The Chronically Ill

The chronically ill person has a long-term degenerative con...

Chloroform

See Child-bearing. ...

Pathologic Physiology

The development of permanent injury to one or more valves o...

Fruits And Vegetables

The Special Uses of Fruits and Vegetables. We come now to t...

Secondary Eliminations Are Disease

However the exact form the chain from irritation or malnutrit...

Aortic Stenosis

Aortic narrowing or stenosis is a frequent occurrence in the ...

Diet For The Acutely Ill

The acutely ill person experiences occasional attacks of dist...

Heartburn

This peculiar burning and distressed feeling at the stomach d...

Purple Spots On Skin

These arise first as small swellings. The swellings fall, and ...

Prognosis And Convalescence

The duration of acute endocarditis varies greatly; it may be ...

Diet For The Lean

To a large extent the preceding article will suggest what is s...

Rose

See Erysipelas. ...

Stone

See Gravel. ...

Do Not Hurry

HOW can any one do anything well while in a constant ...

Cold Settled

A cold is often easily overcome. At other times it "sits down,...

On The Unadherent Eschar

The eschar is generally adherent in cases of recent injuries,...

Indications For Esophagoscopy In Disease

Any persistent abnormal sensation or disturbance of function...



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 1215