Answer BOF 13

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BOF: 13

A 63 year old male who is known to have chronic obstructive pulmonary disease presents with worsening breathlessness and swelling of his ankles.

In this patient which of the following physical signs would make you suspect that the patient has left ventricular failure?

a)   Bilateral basal crepitations

b)   Pitting ankle oedema

c)    Pulsus alternans

d)   Elevated JVP

e)   Third heart sound

Answer: c)

Pulsus alternans refers to alternating high and low volume pulses and signifies left ventricular failure

The other signs may occur in COPD and cor pulmonale

Revision Tip

Revise radial pulse ACES for PACES page 190-195

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