{"id":21094,"date":"2015-12-18T20:30:44","date_gmt":"2015-12-18T15:00:44","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21094"},"modified":"2015-12-18T20:30:44","modified_gmt":"2015-12-18T15:00:44","slug":"diastolic-pulsus-alternans","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/","title":{"rendered":"Diastolic pulsus alternans"},"content":{"rendered":"

Diastolic pulsus alternans<\/span><\/h2>\n

Though there is no pulse felt in diastole, diastolic pulsus alternans (DPA) has been described as the alternation of mitral inflow velocities. In one case it was due dilated cardiomyopathy and pulmonary embolism [1]. Another report was in severe heart failure [2] where they demonstrated both DPA and systolic pulsus alternans. Alternation in ventricular diastolic function can be documented both by Doppler echo and Tissue Doppler imaging [3]. Continuous wave Doppler (CW) interrogation showed alternation of beat to beat aortic flow velocity with peak velocity alternating between 80 centimeters per second and 40 centimeters per second, a surrogate of systolic alternans. Peak early diastolic mitral annular velocity alternated between 8 centimeters per second and 6 centimeters per second, indicating diastolic alternans.<\/p>\n

Earlier description of DPA was alternation in the left ventricular diastolic pressures, as in a case of hypertrophic cardiomyopathy [4]. They noted that DPA was not corrected by isoprenaline infusion. They presumed that it is possibly independent of systolic pulsus alternans.<\/p>\n

Reference<\/strong><\/span><\/h4>\n
    \n
  1. Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P. “Like a sound and its echo”. Biventricular pulsus alternans.\u00a0Heart. 2014 Jan;100(1):83, 90.<\/li>\n
  2. Perk G, Tunick PA, Kronzon I. J Am Soc Echocardiogr. 2007 Jul;20(7):905.e5-7.<\/a><\/li>\n
  3. Edwards P, Cohen GI. Both diastolic and systolic function alternate in pulsus alternans: a case report and review.\u00a0J Am Soc Echocardiogr. 2003 Jun;16(6):695-7.<\/li>\n
  4. Yamakado T, Oomichi C, Maeda M, Yamada N, Shibata M, Kakimoto H, Nakano T. Heart Vessels. 1994;9(5):969-72<\/a>.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Diastolic pulsus alternans Though there is no pulse felt in diastole, diastolic pulsus alternans (DPA) has been described as the alternation of mitral inflow velocities. In one case it was due dilated cardiomyopathy and pulmonary embolism [1]. Another report was in severe heart failure [2] where they demonstrated both DPA and systolic pulsus alternans. Alternation […]<\/p>\n","protected":false},"author":1,"featured_media":32890,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-21094","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"\ndiastolic pulsus alternans is the alternation of mitral inflow velocities<\/title>\n<meta name=\"description\" content=\"Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as\u00a0the alternation of mitral inflow velocities.\" \/>\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\/diastolic-pulsus-alternans\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"diastolic pulsus alternans is the alternation of mitral inflow velocities\" \/>\n<meta property=\"og:description\" content=\"Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as\u00a0the alternation of mitral inflow velocities.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2015-12-18T15:00:44+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\\\/diastolic-pulsus-alternans\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Diastolic pulsus alternans\",\"datePublished\":\"2015-12-18T15:00:44+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/\"},\"wordCount\":234,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/\",\"name\":\"diastolic pulsus alternans is the alternation of mitral inflow velocities\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2015-12-18T15:00:44+00:00\",\"description\":\"Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as\u00a0the alternation of mitral inflow velocities.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/diastolic-pulsus-alternans\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Diastolic 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":"diastolic pulsus alternans is the alternation of mitral inflow velocities","description":"Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as\u00a0the alternation of mitral inflow velocities.","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\/diastolic-pulsus-alternans\/","og_locale":"en_US","og_type":"article","og_title":"diastolic pulsus alternans is the alternation of mitral inflow velocities","og_description":"Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as\u00a0the alternation of mitral inflow velocities.","og_url":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2015-12-18T15:00:44+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\/diastolic-pulsus-alternans\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"Diastolic pulsus alternans","datePublished":"2015-12-18T15:00:44+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/"},"wordCount":234,"commentCount":0,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#primaryimage"},"thumbnailUrl":"","articleSection":["General Cardiology"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/","url":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/","name":"diastolic pulsus alternans is the alternation of mitral inflow velocities","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#primaryimage"},"thumbnailUrl":"","datePublished":"2015-12-18T15:00:44+00:00","description":"Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as\u00a0the alternation of mitral inflow velocities.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/diastolic-pulsus-alternans\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"Diastolic 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\/21094","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=21094"}],"version-history":[{"count":0,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/21094\/revisions"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=21094"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=21094"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=21094"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}