Hello!
Thank you for asking on HCM!
Regarding your concern, I would explain that first of all it is important to differentiate pulsus bigeminus form pulsus alternans by cardiac auscultation, as there is a lot of confusion between them.
It may be a sign of hypertrophic obstructive csrdiomyopathy, or other disorders, like possible effect of
beta-blocker use, dyskalemia,
hypothyroidism, disorders of the cardiac conductance system, etc.
I recommend you to don't panic! As long as you are free of any disturbing symptomatology, and do not exert clnical signs and symptoms of
heart failure, you don't have to worry too much!
Probably we have to do only with some
extrasystoles without any clinical significance.
Nevertheless, I recommend you to consult your cardiologist for a careful physical examination (including cardiac ousculatation), and a comprehesive review of your cardiac condition, to rule out any possible underlying factors.
Hope to have been helpful to you! Greetings! Dr. Iliri