SAMUEL ZONERAICH, M.D.; OLGA ZONERAICH, M.D.
To the editor: Pulsus alternans is considered a severe sign of heart disease. It can occur simultaneously or independently in the systemic and pulmonic circulations.
This letter presents the first case of alternance in the jugular pulse detected by conventional pulse recording in a patient with right heart failure.
This 20-year-old man was hospitalized with fever, cough, and hemoptysis. He was known to have a congenital heart disease. Cardiac catheterization showed a ventricular septal defect with severe pulmonary hypertension and bidirectional shunts. At admission the patient was cyanotic and had clubbing and distension of the neck veins. A left parasternal
ZONERAICH S, ZONERAICH O. Alternation in Jugular Pulse. Ann Intern Med. ;78:609–611. doi: 10.7326/0003-4819-78-4-609_2
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Published: Ann Intern Med. 1973;78(4):609-611.
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