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It is almost always indicative of left ventricular systolic impairment, and carries a poor prognosis. The condition is relatively rare, and patients with the greatest risk for developing pulsus alternans include those with heart failure, cardiomyopathy, coronary artery disease, or other cardiac risk factors. [2]
Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome caused by an impairment in the heart's ability to fill with and pump blood. Although symptoms vary based on which side of the heart is affected, HF typically presents with shortness of breath, excessive fatigue, and bilateral leg swelling. [3]
In medicine, the pulse is the rhythmic throbbing of each artery in response to the cardiac cycle (heartbeat). [1] The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the neck (carotid artery), wrist (radial artery or ulnar artery), at the groin (femoral artery), behind the knee (popliteal artery), near the ankle joint ...
A gallop rhythm refers to a (usually abnormal) rhythm of the heart on auscultation. [1] It includes three or four sounds, thus resembling the sounds of a gallop . The normal heart rhythm contains two audible heart sounds called S 1 and S 2 that give the well-known "lub-dub" rhythm; they are caused by the closing of valves in the heart.
The third heart sound, or S 3 is rarely heard, and is also called a protodiastolic gallop, ventricular gallop, or informally the "Kentucky" gallop as an onomatopoeic reference to the rhythm and stress of S1 followed by S2 and S3 together (S1=Ken; S2=tuck; S3=y). [2] "lub-dub-ta" or "slosh-ing-in" If new, indicates heart failure or volume overload.
This heart sound when present in a child or young adult implies the presence of a supple ventricle that can undergo rapid filling. Conversely, when heard in a middle-aged or older adult, an S 3 is often a sign of disease, indicating increased ventricular filling due to congestive heart failure or severe mitral or tricuspid regurgitation. [6]