{"id":21091,"date":"2015-12-18T19:57:43","date_gmt":"2015-12-18T14:27:43","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21091"},"modified":"2015-12-18T19:57:43","modified_gmt":"2015-12-18T14:27:43","slug":"biventricular-pulsus-alternans","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/","title":{"rendered":"Biventricular pulsus alternans"},"content":{"rendered":"

Biventricular pulsus alternans (BVPA)<\/span><\/h2>\n

Pulsus alternans is alternating volume of pulse, with a regular rhythm, mostly seen with severe left ventricular dysfunction. Biventricular and right ventricular pulsus alternans<\/a> needs cardiac catheterization or Doppler echocardiography to demonstrate the alternating right ventricular or pulmonary artery systolic pressures. BVPA is much rarer than left ventricular pulsus alternans.<\/p>\n

One case reported was biventricular pulsus alternans due to anterior wall myocardial infarction [1]. The left ventricular ejection fraction was 31% and BVPA was demonstrated during cardiac catheterization as beat to beat variation in aortic, pulmonary artery, left ventricular and right ventricular systolic pressures.<\/p>\n

Another report was an echocardiographic demonstration of BVPA by echocardiography in a case of pulmonary embolism [2]. A combination of dilated cardiomyopathy and pulmonary embolism was responsible for BVPA in another case [3]. The demonstration of alternans was the alternating left ventricular and right ventricular outflow velocities. A diastolic alternans was also described in the inflow velocities, though strictly the term diastolic pulsus alternans is not ideal because there is no pulse in diastole in this case!<\/p>\n

References<\/strong><\/span><\/p>\n

    \n
  1. Vidwan P, Stouffer GA. Cardiol Res Pract. 2009;2009:703793<\/a>.<\/li>\n
  2. Nguyen T, Cao LB, Tran M, Movahed A. World J Clin Cases. 2013 Aug 16;1(5):162-5<\/a>.<\/li>\n
  3. Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P. Heart. 2014 Jan;100(1):83, 90<\/a>.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Biventricular pulsus alternans (BVPA) Pulsus alternans is alternating volume of pulse, with a regular rhythm, mostly seen with severe left ventricular dysfunction. Biventricular and right ventricular pulsus alternans needs cardiac catheterization or Doppler echocardiography to demonstrate the alternating right ventricular or pulmonary artery systolic pressures. BVPA is much rarer than left ventricular pulsus alternans. One […]<\/p>\n","protected":false},"author":1,"featured_media":32903,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-21091","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"\nBiventricular pulsus alternans - needs cath or Doppler<\/title>\n<meta name=\"description\" content=\"Biventricular and right ventricular pulsus alternans needs cardiac catheterization or\u00a0Doppler echocardiography to\u00a0demonstrate the alternans.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Biventricular pulsus alternans - needs cath or Doppler\" \/>\n<meta property=\"og:description\" content=\"Biventricular and right ventricular pulsus alternans needs cardiac catheterization or\u00a0Doppler echocardiography to\u00a0demonstrate the alternans.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2015-12-18T14:27:43+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Biventricular pulsus alternans\",\"datePublished\":\"2015-12-18T14:27:43+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/\"},\"wordCount\":206,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/\",\"name\":\"Biventricular pulsus alternans - needs cath or Doppler\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2015-12-18T14:27:43+00:00\",\"description\":\"Biventricular and right ventricular pulsus alternans needs cardiac catheterization or\u00a0Doppler echocardiography to\u00a0demonstrate the alternans.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/biventricular-pulsus-alternans\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Biventricular pulsus alternans\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Biventricular pulsus alternans - needs cath or Doppler","description":"Biventricular and right ventricular pulsus alternans needs cardiac catheterization or\u00a0Doppler echocardiography to\u00a0demonstrate the alternans.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/","og_locale":"en_US","og_type":"article","og_title":"Biventricular pulsus alternans - needs cath or Doppler","og_description":"Biventricular and right ventricular pulsus alternans needs cardiac catheterization or\u00a0Doppler echocardiography to\u00a0demonstrate the alternans.","og_url":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2015-12-18T14:27:43+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"Biventricular pulsus alternans","datePublished":"2015-12-18T14:27:43+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/"},"wordCount":206,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#primaryimage"},"thumbnailUrl":"","articleSection":["General Cardiology"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/","url":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/","name":"Biventricular pulsus alternans - needs cath or Doppler","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#primaryimage"},"thumbnailUrl":"","datePublished":"2015-12-18T14:27:43+00:00","description":"Biventricular and right ventricular pulsus alternans needs cardiac catheterization or\u00a0Doppler echocardiography to\u00a0demonstrate the alternans.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/biventricular-pulsus-alternans\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"Biventricular pulsus alternans"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/21091","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=21091"}],"version-history":[{"count":0,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/21091\/revisions"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=21091"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=21091"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=21091"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}