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Figure 1. Physical examination of two patients with severe left ventricular failure revealed pulsus alternans in the radial pulse. Pulsus alternans is a physical finding characterized by a regular alternation of the force of the arterial pulse. It almost invariably indicates the presence of severe left ventricular systolic dysfunction.
Panel A shows a simultaneous electrocardiogram (ECG), phonocardiogram, and carotid-pulse tracing in a 64-year-old man with an ejection fraction of 15 percent due to dilated cardiomyopathy. Alternating strong and weak beats are seen in the carotid pulse tracing that corresponded to an alternation of approximately 40 mm Hg in the . . . [Full Text of this Article] |