Doppler alternans in pediatric emergency: correlation between clinical, Doppler waveforms and silent ventricular dysfunction by POCUS echo


  • Munesh Tomar Department of Pediatrics, LLRM Medical College, Meerut Uttar Pradesh, India
  • Maitri Chaudhuri Department of Pediatrics Cardiology, Manipal Hospital, Bangalore, Karnataka, India
  • Hariraj Singh Tomar Department of Pediatrics Cardiology, Manipal Hospital, Bangalore, Karnataka, India



POCUS, PA, Aorta Doppler, Ventricular dysfunction


Pulsus alternans (PA), reported in nineteenth century, is a subtle abnormality, often missed in emergency situations. However, the significance lies in its association with severe ventricular dysfunction. This case reports an 8-year-old child presenting with heart failure in emergency department. Abdominal aortic Doppler displayed pulsus/Doppler alternans. Step by step investigation of Doppler clue unearthed severe left ventricular dysfunction secondary to systemic arterial hypertension.


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