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Updated: May 31, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Murmur and Doppler alternans in critical pulmonary stenosis
Mehnaz Atiq1, Saleem Akhter, Sheikh Abdul Sattar
1Department of Pediatrics and Child Health, Aga Khan University Hospital, PO Box 3500, Stadium Road, Karachi 74800, Pakistan. mehnaz.atiq@aku.edu
Abstract:
Pulsus alternans is a well-recognized clinical entity in which alternating strong and weak pulses are detected. It usually is secondary to underlying myocardial failure. Murmur alternans (alternation in murmur intensity) has been described in aortic stenosis and a few right-sided lesions such as pulmonary hypertension and embolism. This report describes a case of murmur alternans in critical pulmonary stenosis that also showed Doppler alternans on echocardiography. The underlying cause was right ventricular systolic dysfunction.
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