Pulsus bigeminus
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]
Overview
Pulsus bigeminus is a cardiovascular phenomenon, in which two heartbeats occur close to each other followed by a long pause. The second pulse is weaker than the first, and it is caused by premature contractions after every other beat, usually of the ventricles.
Causes
Overview
Pulsus bigeminus may be innocent and a temporary phenomenon, but mostly seen in cases of hypertrophic obstructive cardiomyopathy.
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. Pulsus bigeminus in itself is not a life threatening condition.
Common Causes
The most common cause of pulsus bigeminus is hypertrophic obstructive cardiomyopathy, other causes include:
Causes by Organ System
| Cardiovascular | Hypertrophic obstructive cardiomyopathy, myocardial infarction |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug and Toxin Side Effect | Beta blocker, calcium channel blocker, digoxin |
| Ear Nose Throat | No underlying causes |
| Endocrine | Hypothyroidism |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | [No underlying causes |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying cause |
| Infectious Disease | No underlying causes |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying cause |
| Nutritional / Metabolic | No underlying cause |
| Obstetric/Gynecologic | No underlying cause |
| Oncologic | No underlying causes |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | [No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | No underlying causes |
| Renal / Electrolyte | Hyperkalemia |
| Rheum / Immune / Allergy | No underlying causes |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
- Beta blocker
- Calcium channel blocker
- Digoxin
- Hypertrophic obstructive cardiomyopathy
- Hyperkalemia
- Hypothyroidism
- Myocardial Infarction