Abstract
Pulsus alternans was observed in a child with left ventricular dysfunction secondary to systemic hypertension. The Echo-Doppler of supravalvular aorta and a simultaneous electrocardiographic trace (ECG) clearly demonstrated the mechanism of an apparent abrupt halving of pulse frequency compared with the ECG, similar to an electromechanical dissociation 2:1. Besides the extreme pulsus alternans, a P wave and a PP cycle length change were also observed. Both mechanical and electrical alternans disappeared with afterload reduction by nitroprusside treatment.
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Pipitone, S., Giudice, G., Giuffrè, M. et al. Extreme Pulsus Alternans with P Wave Alternans in a Child . Pediatr Cardiol 23, 557–561 (2002). https://doi.org/10.1007/PL00021004
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DOI: https://doi.org/10.1007/PL00021004