title: Extreme pulsus alternans with P wave alternans in a child.
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.
authors.affiliation: Divisione di Cardiologia, Ospedale Casa del Sole, Palermo, Italy. spipiton@neomedia.it
authors.forename: S
authors.initials: S
authors.lastname: Pipitone
authors.forename: G
authors.initials: G
authors.lastname: Giudice
authors.forename: M
authors.initials: M
authors.lastname: Giuffrè
authors.forename: V
authors.initials: V
authors.lastname: Sperandeo
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D002302:Cardiac Output / Q000502:physiology; D002648:Child; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008297:Male; D009599:Nitroprusside / Q000627:therapeutic use; D011674:Pulse; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents; D009599:Nitroprusside