The alternating pulse refers to a normal pulse rate, but the patient has alternating strong and weak pulses. Clinically, the alternating pulse is used to determine the manifestation of occult heart failure. The appearance of alternating pulses is often closely related to the strength of left ventricular contraction, and its causes are mainly seen in various organic heart diseases that cause left heart failure, and the main causes include hypertension, coronary artery disease, dilated cardiomyopathy, etc. The presence of alternating pulses should be considered organic heart disease, and if there is no organic heart disease, herbal treatment can be considered. TCM believes that alternating veins are closely related to heart-yang deficiency and heart-blood stasis, and can be treated with drugs that benefit qi, invigorate blood, and resolve stasis.