Right ventricular pulsus alternans can be isolated or associated with left ventricular pulsus alternans. Right ventricular and pulmonary artery pulsus alternans are demonstrated by cardiac catheterization studies. In one case of right ventricular pulsus alternans due to right ventricular infarction, improvement was obtained by coronary sinus pacing .
Doppler alternans and murmur alternans corresponding to right ventricular pulsus alternans has been noted in critical pulmonary stenosis with right ventricular dysfunction . Pulmonary embolism and pulmonary hypertension  are other situations in which right sided pulsus alternans can be observed.
A rare occurrence of right sided pulsus alternans was in a case of prosthetic mitral valve thrombosis . In an interesting case of right pulsus alternans in left ventricular diastolic dysfunction, pulsus alternans was demonstrated in right ventricle, pulmonary artery and pulmonary artery wedge positions, but not in the left ventricle or aorta .
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