Electrical Alternans: Causes & Reasons

Possible Causes for Electrical Alternans

[…] pericardial effusion produces a triad of: Low QRS voltage Tachycardia Electrical alternans ECG findings with Electrical alternans Electrical alternans occurs when consecutive [lifeinthefastlane.com]

Electrical Alternans 5. [slideshare.net]

Electrical alternans vs. pseudoelectrical alternans. [lifeinthefastlane.com]

Cardiac Tamponade

Electrical alternans – i.e the beat-to-beat variation i electrical amplitude – is the ECG hallmark of cardiac tamponade. [ecgwaves.com]

The electrocardiogram showed low-voltage QRS complex with electrical alternans. [ncbi.nlm.nih.gov]

EKG 1,4 => low voltage QRS, tachycardia, electrical alternans, PR depression, non-specific ST-T wave changes CXR 1,4 => increased cardiac silhouette as compared to previous [emdocs.net]

Malignant Pericardial Effusion

RESULTS: For PEs of all sizes, the Se, Sp, PPV, and NPV for detecting cardiac tamponade were: low-voltage complexes (56%, 74%, 81%, 46%), electrical alternans (23%, 98%, 95% [ncbi.nlm.nih.gov]

EKG showing sinus tachycardia, low QRS voltage and electric alternans, suggesting pericardial effusion. Figure 2. C hest X-ray pre- and post-pericardiocentesis. [swjpcc.com]

At initial evaluation, a chest radiograph may provide evidence of an enlarged cardiac silhouette, while at electrocardiography (ECG) low-voltage complexes and electrical alternans [oncologypro.esmo.org]

Dissecting Aortic Aneurysm

alternans (tamponade) Laboratory leukocytosis Cr elevation with renal artery involvement tropnonin elevated if dissection causes myocardial ischaemia D-dimer – if negative [lifeinthefastlane.com]

[…] liver) death INVESTIGATIONS Bedside ECG normal inferior ST elevation (right coronary dissection) but can be any STEMI (0.1% of STEMIs are dissections) pericarditis changes, electrical [lifeinthefastlane.com]

Pericardial Disorder

Electrical alternans – i.e the beat-to-beat variation i electrical amplitude – is the ECG hallmark of cardiac tamponade. [ecgwaves.com]

C, Beat-to-beat variations in amplitude and contour of the QRS and ST-T complexes that characterize electrical alternans. [veteriankey.com]

alternans Signs of severe pericardial tamponade : ST segment elevation T wave flattening or inversion Pericardial fluid drainage : used to sample the effusion in cases of [amboss.com]

Pericardial Calcification

alternans ECHO – diagnostic, echo-free zone around the heart, diastolic collapse of RA&RV Management : Seek expert help Urgent drainage Send fluid for culture, ZN stain/TB [wikilectures.eu]

In cardiac tamponade, the ECG shows electrical alternans as the heart “floats” in relation to the recording leads. [aafp.org]

Electrical alternans is associated with variation in cardiac position (swinging heart). [merckmanuals.com]

Post-Infarction Pericarditis

alternans Electrical alternans in pericardial effusion varying QRS heights with each successive beat DMOC for pericardial effusion Echo! [quizlet.com]

EKG shows electrical alternans. Emergency echocardiography with pericardiocentesis is performed. --> Cardiac tamponade [forums.studentdoctor.net]

Electrical alternans is associated with variation in cardiac position (swinging heart). [merckmanuals.com]

Pericardial Neoplasm

Electrical alternans is not seen in most cases of cardiac tamponade. [patient.info]

ECG was significant for electrical alternans with sinus tachycardia. [scientificoajournals.org]

[citation needed] ECG: may present with sinus tachycardia, low voltage QRS as well as electrical alternans.[2] Due to the fluid accumulation around the heart, the heart is [en.wikipedia.org]

Radiation Pericarditis

In cardiac tamponade, the ECG shows electrical alternans as the heart “floats” in relation to the recording leads. [aafp.org]

ELECTROCARDIOGRAM (see Table 10 ) may show low voltage and electrical alternans. [brown.edu]

In such cases of cardiac tamponade, EKG or Holter monitor will then depict electrical alternans indicating wobbling of the heart in the fluid filled pericardium, and the capillary [en.wikipedia.org]

Acute Pleuropericarditis

Electrical alternans is not seen in most cases of cardiac tamponade. [patient.info]

In patients with cardiac tamponade, the EKG may show signs of pericarditis, with especially low QRS voltages and electrical alternans 3. [en.my-ekg.com]

alternans (Figure 3). [jucm.com]

Diffuse Intraventricular Block

Pacemaker See the chapter Pacemaker Tamponade Electrical alternans on the ECG In case of tamponade, fluid collects in the pericardium. [en.ecgpedia.org]

Electrical alternans occurs when every other QRS complex has varying amplitudes and is from the heart swaying within a large pericardial effusion. [healio.com]

Electrical alternans can also be seen in myocardial ischemia, acute pulmonary embolism, and tachyarrhythmias PR segment depression (this can also be observed in an atrial [en.ecgpedia.org]

Suppurative Pericarditis

Electrical alternans. 3. Chest-X-ray. Cardiac shadow will be enlarged, if pericardial effusion is more than 250ml. [drnajeeblectures.com]

In cardiac tamponade, the ECG may show electrical alternans associated with cardiac motion as the heart "floats" in relation to the recording leads. [atsu.edu]

Pericarditis

Electrical alternans, sinus tachycardia, and PR-segment depression are major signs in pericarditis. [dergipark.org.tr]

When severe, the extent of this motion alternates and may be associated with electrical alternans. [journals.lww.com]

In cardiac tamponade, the ECG shows electrical alternans as the heart “floats” in relation to the recording leads. [aafp.org]

Atrial Bigeminy

[…] jeff Paramedic Electrical alternans. JB4B Paramedic Atrial bigemeny, lial Registered Nurse Atrial bigeminy, unifocal PACs. [app.figure1.com]

I was thinking electrical alternans associated with tamponade (always assuming the worst, I hurried to double-check my chest tubes). [allnurses.com]

Heart swinging back and forth in fluid. land Medical Student Electrical alternans. Classic ekg finding in pericardial effusion or tamponade. [app.figure1.com]

Pericardiocentesis

The heart is “swinging” in the fluid, which correlates with electrical alternans on the EKG. [coreem.net]

ECG – electrical alternans, low voltage QRS. [aci.health.nsw.gov.au]

alternans (the R wave amplitude varies from beat to beat as the heart swings in the sac of fluid and is unrelated to the respiratory cycle) Point of Care Ultrasound (POCUS [coreem.net]

Hemopericardium

Electrical alternans was completely absent (Figure 1). [jeccm.amegroups.com]

alternans in larger effusions Findings in cardiac tamponade [4] Sinus tachycardia Low voltage QRS complexes Electrical alternans: consecutive QRS complexes that alternate [amboss.com]

alternans caused by “swinging” of the oscillating heart in the buoyant pericardial sac.13 Echocardiography is the primary diagnostic method for initial detection of pericardial [ncbi.nlm.nih.gov]

Congenital Pericardium Anomaly

Prior reports have noted electrical alternans, alteration of both P and QRS vectors, which is likely due to increased mobility and unusual intrathoracic position of the heart [academic.oup.com]

Long QT Syndrome 4

T wave electric alternans. 7. LQTS3 genotype. [revespcardiol.org]

A: T wave electrical alternans. B: atrioventricular block 2:1. C: self-limited torsade de pointes. [revespcardiol.org]

It is an indicator of electrical instability,43 reflecting regional dispersion of ventricular repolarization, and occasionally precedes ventricular fibrillation.44 Figure [revespcardiol.org]

Familial Pericarditis

There may also be diminished QRS and T-wave voltages, PR-segment depression, ST-T changes, bundle branch block and electrical alternans. [patient.info]

alternans電気的交互脈 electrocardiogram (ECG) 心電図 electrocardiography 心電［図］学（法） electrode電極 electrophysiological study (EPS)電気生理検査 embolism塞栓[症] embolus塞栓、栓子〈emboli（複数）〉 emergency [tokyo-med.ac.jp]

Traumatic Heart Rupture

Electrocardiography may show signs of large pericardial effusion, with especially low QRS voltage and electrical alternans 4, which is an electrocardiographic phenomenon defined [acls.com]

ECG With Electrical Alternans BCI clearly presents both diagnostic and management challenges to the emergency physician. [ahcmedia.com]

Muffled heart sounds, jugular venous distention, hypotension (Beck's triad), and electrical alternans are also prototypical findings of tamponade. [ahcmedia.com]

Hydropericardium

There may also be diminished QRS and T-wave voltages, PR-segment depression, ST-T changes, bundle branch block and electrical alternans. [patient.info]

Sometimes, large pericardial effusions may exhibit electrical alternation of QRRS voltage or "pulsus alternans" reflecting free swing of the heart within the pericardial fluid [emedicine.medscape.com]

[…] with shifting electrical axis. [emedicine.medscape.com]

Paroxysmal Nodal Tachycardia

Electrical Alternans Electrical Alternans is diagnosed when the P, QRS, or T complexes (or any combination) alter their configurations on every other complex, every third [research.vet.upenn.edu]

QRS alternans – phasic variation in QRS amplitude associated with AVNRT and AVRT, distinguished from electrical alternans by a normal QRS amplitude. [litfl.com]

Electrical Alternans occurs with significant pericardial effusions which allow the heart to swing within the pericardial sac with every beat. [research.vet.upenn.edu]

Lateral Myocardial Infarction

Alternans, Ventricular Hypertrophy, Complete and Incomplete Right Bundle Branch Block, Left Anterior Fascicular Block, Left Posterior Fascicular Block, Complete and Incomplete [play.google.com]

Idioventricular Rhythm, Ventricular Fibrillation, AV Block, (1st Degree, 2nd Degree, and 3rd Degree), Wolff-Parkinson-White, AV Dissociation, Low Voltage, Axis Deviation, Electrical [play.google.com]

Acute Pericarditis

In patients with cardiac tamponade, the EKG may show signs of pericarditis, with especially low QRS voltages and electrical alternans 3. [en.my-ekg.com]

Rarely, electrical alternans may be seen, depending on the size of the effusion. [en.wikipedia.org]

Some patients with acute pericarditis and an associated pericardial effusion will manifest an overall lowering of their ECG voltage or have evidence of QRS electrical alternans [clinicaladvisor.com]

Dressler Syndrome

Electrical alternans and/or low voltage QRS complexes may also be observed if there is a large volume pericardial effusion 3. [en.my-ekg.com]

alternans. [en.wikipedia.org]

Both electrical alternans (variation in amplitude or directionality of QRS from beat to beat) and/or a low voltage QRS may also be observed if there is a large volume of pericardial [ncbi.nlm.nih.gov]

Chronic Constrictive Pericarditis

In cardiac tamponade, the ECG shows electrical alternans as the heart “floats” in relation to the recording leads. [aafp.org]

Abnormal findings on ECG include tachycardia, electrical alternans ( Figure 9 ), low voltage, and may include changes associated with acute pericarditis ( Figure 6 ). [clevelandclinicmeded.com]

Patients also should be hospitalized if they have pulsus paradoxus, electrical alternans on the ECG, or a large pericardial effusion. [aafp.org]

Bifascicular Block

• EKG does reveal sinus tachycardia, but not electrical alternans or low voltage. [cmcedmasters.com]

Electrical alternans is usually seen in (narrow complex) circus movement tachycardia and beat-to-beat variations can occur when the atrial rate is half the ventricular rate [academic.oup.com]

[…] activity Sinoatrial arrest Other / ungrouped hexaxial reference system Right axis deviation Left axis deviation QT Short QT syndrome T T wave alternans ST Osborn wave ST [en.wikipedia.org]

Lown-Ganong-Levine Syndrome

Pacemaker See the chapter Pacemaker Tamponade Electrical alternans on the ECG In case of tamponade, fluid collects in the pericardium. [en.ecgpedia.org]

[…] variation in QRS amplitude associated with AVNRT and AVRT, distinguished from electrical alternans by a normal QRS amplitude T wave inversion common ST segment depression [lifeinthefastlane.com]

Electrical alternans can also be seen in myocardial ischemia, acute pulmonary embolism, and tachyarrhythmias PR segment depression (this can also be observed in an atrial [en.ecgpedia.org]

Conduction Disorder of the Heart

Alternans, Ventricular Hypertrophy, Complete and Incomplete Right Bundle Branch Block, Left Anterior Fascicular Block, Left Posterior Fascicular Block, Complete and Incomplete [play.google.com]

Acute Aortic Regurgitation

alternans (tamponade) Laboratory leukocytosis Cr elevation with renal artery involvement tropnonin elevated if dissection causes myocardial ischaemia D-dimer – if negative [lifeinthefastlane.com]