The grave significance of pulsus alternans has been abundantly confirmed. Any simple method for the detection of the condition certainly deserves emphasis. Herrick1 calls attention to the value of the sphygmomanometer in diagnosing alternating pulse. He says:
When the systolic pressure is being tested in a patient in whom an alternating pulse is present, a manometer pressure may be reached that cuts off every other beat—the weaker beat—thus halving the rate of the pulse at the wrist.
I have used the same method for some time and have found it reliable and most helpful. The following case illustrates the condition and confirms Herrick's findings. In this case the effect of digitalis therapy on pulsus alternans is well shown merely by following the blood pressure. The blood pressure was taken by the auscultatory method.
Mr. X., aged 53, entered Murray Hospital, Dec. 4, 1914, complaining of marked dyspnea and a
McGILL C. THE DETERMINATION OF PULSUS ALTERNANS BY THE SPHYGMOMANOMETER. JAMA. 1915;LXIV(25):2061–2062. doi:10.1001/jama.1915.02570510037014
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