The standard grips this chord is usually shown with.
Aalt is A, C#, E#, G and Bb, a altered dominant. The shape this page opens on is written x0122x, lowest string first.
Note by note. A is the root, C# is the major third, E# is the sharp fifth, G is the flat seventh and Bb is the flat ninth.

Also written A7alt, A7altered or A altered dominant. The same chord either way; which spelling you meet depends on who wrote the chart.
There are 10 common shapes for Aalt on the guitar, and 24 derived voicings in 3 families.
One note away. Change a single note of Aalt and you have Aaug7 (with one note taken away), Aaug9 (with one note moved) or A7b9 (with one note moved).
The common shapes, written lowest string first: x0122x, x07645, 54x645, xx7645, 5676x5, x-x-7-8-10-9, x-0-11-8-10-9, x-12-11-x-10-11, x-12-11-14-14-11, x-12-13-14-14-x.
Under the hand. 2 of the 10 shapes here sit in open position, and the first uses 1 open string with 2 left unplayed. None of them needs a barre. Together they cover the neck from the 1st fret to the 14th.
Where it goes. Aalt is a dominant with its tension raised, so it still points at D — harder than a plain seventh does, because the altered tones sit a semitone from where they are going.
Shell. Root, third and seventh: the guide tones fix the quality, so the fifth is dropped. That is what leaves a string free, so pick a tension to put on top. Aalt has 5453xx, x0566x, xx7686, x-12-11-12-11-x, x0x021, x0x026, 5x566x, x-12-x-12-14-13.
Rootless. The root left to the bass player. Frees a finger for a tension. Aalt has x1302x, xx3323, xx5666, x8868x, x-x-8-10-8-9, x-10-11-10-11-x, x-x-11-12-11-13, x-x-15-15-14-15.
Open string. An open string left ringing against a fretted grip. Because it costs no finger, it sounds a note the closed shape has none left for -- a tension on top, or a pedal root underneath. Either a familiar grip with open strings added, or a shape so sparse the open strings carry the chord. These belong to their key rather than to a shape, so D, A, G and E have many and Eb a handful. Aalt has x03323.
Tensions. A shell of Aalt, root, third and seventh, leaves a string free, and the tones that belong over it are the #11 (D#).
What kind of chord this is. Aalt is an altered chord — a dominant seventh with its fifth or ninth moved. altered dominant chords on every root, and what they are for.
The common shapes and the derived voicings come from different places, and both are explained in where the chords and the theory come from.
Shows each chord the way this style would voice it, and marks which of its alternatives belong to the idiom.