Conversation: The conversation between human and AI assistant.
[|Human|] I have developed recently (a few months back) pulsus bigeminus. No cardiac failure, no clinical signs of heart disease, only long lasting hypertension. Present treatment consists of Micardis 40 mg bd, Adalat Oros 20 mg bd, Tenormin 20 mg mane, Lipitor 40 mg PM. ECG shows no significant changes. Should I worry?
[|AI|]  Hello! Thank you for asking on Chat Doctor! Regarding your concern, I would explain that first it is important to differentiate pulses bituminous form pulses alternate by cardiac auscultation, as there is a lot of confusion between them. It may be a sign of hypertrophic obstructive cardiomyopathy, or other disorders, like possible effect of beta-blocker use, dyslexia, 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 clinical 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 auscultation), and a comprehensive review of your cardiac condition, to rule out any possible underlying factors. Hope to have been helpful to you! Greetings!