Electrical Alternans Clinical Presentation

Updated: Feb 27, 2014
  • Author: Eric Gorgon Shaw, MD, FACEP, FAAEM, FAWM; Chief Editor: Jeffrey N Rottman, MD  more...
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History

The presence of electrical alternans has no clinical manifestations outside those present from the underlying cause or association. A search for the underlying cause of electrical alternans is warranted. For example, the patient with ST-T alternans may complain of chest pain, shortness of breath, or profuse sweating caused by myocardial ischemia. The patient with QRS alternans may complain of syncope resulting from underlying hypertrophic cardiomyopathy.

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Physical

Electrical alternans does not result in physical findings separate from the underlying cause of the alternans. A physical examination, searching for the underlying cause, is necessary. This may reveal, for example, jugular venous distention and hypotension from cardiac tamponade. Making the distinction between electrical alternans and mechanical alternans is important. Mechanical alternans may have physical findings (eg, pulsus alternans).

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Causes

See the list below:

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