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Pulsus Alternans Its Response to Amyl Nitrite Inhalation

Division of Cardiology, Department of Medicine, The George Washington University School of Medicine and Medical Center, Washington, D.C

Christopher J. Leet

Division of Cardiology, Department of Medicine, The George Washington University School of Medicine and Medical Center, Washington, D.C

Marked pulsus alternans was observed in a patient with primary congestive car diomyopathy. Afterload reduction with amyl nitrite caused the disappearance of the pulsus alternans. Investigation by phonocardiography, echocardiography, systolic time interval measurement and cardiac catheterization disclosed that during pulsus alternans the weak beat originated following a short diastolic filling period and generated much lower contractile force. This report may be relevant to the currently accepted concepts of afterload reduction in the treatment of chronic congestive heart failure.

Angiology, Vol. 35, No. 2, 115-121 (1984)
DOI: 10.1177/000331978403500208


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