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Pulsus alternans in a child with dilated cardiomyopathy

Published online by Cambridge University Press:  14 December 2017

Hasti Sanandajifar  and
Sarosh P. Batlivala
Hasti Sanandajifar
Affiliation:
Division of Pediatric Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, United States of America Children’s Heart Center, Blair E. Batson Hospital for Children, Jackson, Mississippi, United States of America
Sarosh P. Batlivala*
Affiliation:
Division of Pediatric Cardiology, University of Mississippi Medical Center, Jackson, Mississippi, United States of America Children’s Heart Center, Blair E. Batson Hospital for Children, Jackson, Mississippi, United States of America
*
Correspondence to: S. P. Batlivala, MD, Division of Pediatric Cardiology, University of Mississippi Medical Center, 2500 N. State Street, Jackson, MS 39216, United States of America. Tel: +601 984 5250; Fax: +601 984 5283; E-mail: sbatlivala@umc.edu
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Abstract

A previously healthy 21-month-old presented with new-onset dilated cardiomyopathy. Evaluation noted pulsus alternans, with beat-to-beat alternations in aortic pulse wave amplitude, both clinically and on diagnostic studies. Pulsus alternans is an infrequent, complex pathophysiologic sign often associated with severe heart failure. The mechanisms are incompletely understood, but theorised aetiologies include beat-to-beat changes in left ventricular loading conditions, variations in myocardial oxygen supply/demand, and alternations in myocardial contractility. Recognition of pulsus alternans is important as it provides significant clinical information, may suggest suboptimal medical management, and may be the first warning sign of severe cardiac dysfunction.

Keywords

Cardiomyopathyheart failureechocardiography
Type
Brief Report
Information
Cardiology in the Young , Volume 28 , Issue 3 , March 2018 , pp. 479 - 481
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Copyright
© Cambridge University Press 2017 

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