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South Med J. 2013 Aug;106(8):485-9. doi: 10.1097/SMJ.0b013e3182a1456c.

Electrical alternans: a sign, not a diagnosis.

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1
Cardiology Service, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA. Manju.Goyal.mil@mail.mil

Abstract

Electrical alternans is an electrocardiographic phenomenon defined as an alternating amplitude or axis of the QRS complexes in any or all leads. It is most commonly associated with a large pericardial effusion and impending threat of cardiac tamponade; however, a literature review showed that this electrocardiographic finding can be seen in a variety of other clinical scenarios with varying etiologies and prognoses. Several electrocardiogram examples are presented with a brief review of the potential mechanisms and clinical significance and demonstrate that electrical alternans is more correctly considered an electrocardiographic sign, rather than a diagnosis, with a broad differential for potential etiologies. For some causes, the clinical significance is well known, but for others, further research is needed.

PMID:
23912146
DOI:
10.1097/SMJ.0b013e3182a1456c
[Indexed for MEDLINE]
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