Though there is no pulse felt in diastole, diastolic pulsus alternans has been described as the alternation of mitral inflow velocities. In one case it was due dilated cardiomyopathy and pulmonary embolism . Another report was in severe heart failure . Alternation in ventricular diastolic function can be documented both by Doppler echo and Tissue Doppler imaging .
Earlier description of diastolic pulsus alternans was alternation in the left ventricular diastolic pressures, as in a case of hypertrophic cardiomyopathy .
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