Pancycle aortic incompetence and double alternans in pediatric heart failure

Ann Card Anaesth. 2023 Apr-Jun;26(2):232-234. doi: 10.4103/aca.aca_194_21.

Abstract

A 12-year-old boy presented with bicuspid aortic valve, severe aortic regurgitation, and dilated dysfunctional left ventricle in heart failure. He underwent aortic valve replacement with a 23 mm TTK Chitra heart valve prosthesis (tilting disk). He was gradually weaned off milrinone and noradrenaline in the intensive care. Echocardiography showed severe left ventricular dysfunction with an ejection fraction of 24%. The radial pulse was regular and of normal volume but exactly half that of the heart rate. Evaluation of the rhythm and echocardiography revealed an interesting hemodynamic phenomenon with double alternans.

Keywords: Aortic regurgitation; arterial pulse; heart failure; hemodynamics; left ventricular function.

Publication types

  • Case Reports

MeSH terms

  • Aortic Valve / diagnostic imaging
  • Aortic Valve / surgery
  • Aortic Valve Insufficiency* / complications
  • Aortic Valve Insufficiency* / diagnostic imaging
  • Aortic Valve Insufficiency* / surgery
  • Aortic Valve Stenosis* / surgery
  • Child
  • Heart Failure* / surgery
  • Heart Valve Prosthesis Implantation*
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Stroke Volume