Pulsus alternans induced by glyceryl trinitrate paste in a patient with alcoholic cardiomyopathy.
نویسندگان
چکیده
Application of a small dose of glyceryl trinitrate paste (0.25 in) resulted in severe left ventricular dysfunction with the appearance of pulsus alternans in a patient with alcoholic cardiomyopathy. The echocardiogram showed a reduction in the amplitude and velocity of motion of the left ventricular posterior wall on alternate beats. Leg elevation promptly reversed the pulsus alternans, and the echocardiographic abnormality. Glyceryl trinitrate paste should be used with caution and under close supervision in patients with liver dysfunction.
منابع مشابه
Pulsus alternans determined by biventricular simultaneous systolic time intervals.
This investigation was performed to determine the presence of unilateral or bilateral pulsus alternans in the systemic and pulmonary circulations in heart failure and to estimate the prevalence of pulsus alternans in congestive cardiomyopathy. The subjects were 36 adult patients in heart failure due to a variety of cardiopulmonary diseases. We measured left- and right-sided systolic time interv...
متن کاملAlternating atrial electromechanical dissociation as contributing factor for pulsus alternans.
Ten patients with mechanical pulsus alternans were studied by echocardiography and mechanocardiography. All had been or were in congestive heart failure. An atrial mechanism for pulsus alternans could be identified in two patients: one with primary congestive cardiomyopathy and one after aortic valve replacement for calcific aortic stenosis. Each strong systole was preceded by an "a" wave, whil...
متن کاملMurmur alternans in aortic stenosis.
Acquired aortic stenosis, when severe, often gives rise to pulsus alternans.' Other relatively common causes for pulsus alternans include hypertensive heart disease, coronary artery disease, syphilitic heart disease and cardi~myopathy.~ When pulsus alternans is present, the clinician can usually appreciate it through the use of a sphygmomanometer, in which case when the cuff is infiated to near...
متن کاملParoxysmal Supraventricular Tachycardia with QRS Duration Alternans, Electrical Alternans, and Pulsus Alternans but without Cycle Length Alternans.
UNLABELLED We reported a 60-year-old male patient who had a paroxysmal supraventricular tachycardia with QRS duration alternans (alternation between narrow QRS and wide QRS beats) and electrical alternans, but without any cycle length alternans. In the laboratory, slow-fast atrioventricular nodal reentrant tachycardia was easily induced by an atrial extrastimulus, and the arterial pressure reco...
متن کاملSevere Pulsus Alternans Associated with Primary Myocardial Disease
PULSUS ALTERNANS, first described by Traubel in 1872, is a phenomenon of alternately higher and lower peak systolic pressure in the presence of regular rhythm and independent of respiratory variation. It has been described most commonly in hypertensive and coronary artery disease, syphilitic heart disease,2' 3and acquired aortic stenosis, seldom in congenital aortic stenosis,4 and only occasion...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- British heart journal
دوره 41 3 شماره
صفحات -
تاریخ انتشار 1979