Electrical Alternans Treatment & Management

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

Medical Care

Direct treatment toward correction of the underlying cause of electrical alternans. For example, myocardial infarction should be treated using standard measures (eg, consider thrombolytic administration or PTCA). Long QT syndrome may be treated with removal of offending drugs or correction of metabolic abnormalities.

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Surgical Care

Most diseases that cause true electrical alternans do not require surgical treatment. Pulmonary embolectomy may be required for unresolved large pulmonary emboli. Left-sided cervicothoracic sympathetic ganglionectomy may be required for patients with congenital long QT syndrome who continue to have episodes of syncope despite drug therapy. Recurrent pericardial effusions may benefit from pericardiectomy.

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Consultations

Cardiology consultation is usually indicated.

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Diet

No specific dietary restrictions are required aside from those required for the underlying cause (eg, salt restriction for congestive heart failure).

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Activity

No specific activity restrictions are required aside from those required for the underlying cause (eg, avoidance of stress and strenuous exercise for patients with congenital long QT syndrome in order to prevent an arrhythmia in susceptible patients).

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