Periodic intermittent electromechanical dissociation: Hemodynamic correlate of a malfunctioning mechanical prosthesis

✍ Scribed by Goel, P. K. ;Shahi, M. ;Kumar, A. Sreenivas ;Singh, R. K.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 19 KB
• Volume: 42
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/(sici)1097-0304(199710)42:2<237::aid-ccd37>3.0.co;2-i

✦ Synopsis

We read with interest the case report by Shah et al. [1]. The authors in this report were not able, however, to provide the echo doppler trace of the prosthetic valve inflow that is diagnostic in this situation. We would like to present a simultaneous electrocardiogram and echo doppler trace from a similar patient we recently treated (Fig. 1).

This patient presented with hemodynamic compromise and severe pulmonary hypertension in the early postoperative phase. Examination revealed an irregularly irregular pulse, but the patient had normal sinus rhythm seen on the monitor electrocardiogram.

Echo doppler confirmed the stuck mechanical prosthesis, which was noted to open only intermittently. Normal pulse volume ensued during beats that opened the prosthetic valve, while the rest of the beats produced nearly no cardiac output presenting clinically as an irregularly irregular pulse. The surgical findings and management were similar to the case already reported by Shah et al.