The Influence of Advanced Congestive Heart Failure on Pulsus Alternans

Abstract

Evidence is presented which indicates that in certain instances pulsus alternans may be abolished or diminished in the presence of advanced congestive heart failure. The observations suggest that in severe congestive failure the ventricular filling pressure may increase to the point where it causes the diastolic stretch of the left ventricle to be more equal from one beat to the next. This in turn would bring about more uniform systolic ejections and hence ventricular alternation would disappear or be lessened in degree.