Cardiac Hemodynamics

Cardiac Hemodynamics Student’s Name University of California, San Francisco Course Name and ID Instructor’s Name Date Table of Content TOC \o "1-2" \h \u HYPERLINK \l _Toc17438 1.0. Basics of Cardiac Hemodynamics PAGEREF _Toc17438 \h 3 HYPERLINK \l _Toc4301 Right Atrial Pressure Waveform PAGEREF _Toc4301 \h 4 HYPERLINK \l _Toc28540 Examples of Common Abnormalities in RA filling PAGEREF _Toc28540 \h 5 HYPERLINK \l _Toc17963 Hemodynamics in Valvular Heart Disease PAGEREF _Toc17963 \h 7 HYPERLINK \l _Toc26390 Mitral Stenosis (diastolic gradient LV vs. PW or LA pressure) PAGEREF _Toc26390 \h 8 HYPERLINK \l _Toc24031 Hemodynamics in Cardiomyopathies PAGEREF _Toc24031 \h 9 HYPERLINK \l _Toc21399 Hypertrophic Obstructive Cardiomyopathy PAGEREF _Toc21399 \h 9 HYPERLINK \l _Toc28711 Left Ventricle Outflow Gradient Pre-and Post Alcohol Septal Ablation PAGEREF _Toc28711 \h 10 HYPERLINK \l _Toc15741 Hemodynamics in Pericardial Disease PAGEREF _Toc15741 \h 10 HYPERLINK \l _Toc22494 Dip and Plateau Configuration (RV filling) PAGEREF _Toc22494 \h 10 HYPERLINK \l _Toc32575 Sensitivity and Specificity of Hemodynamic Parameters PAGEREF _Toc32575 \h 11 Basics of Cardiac Hemodynamics First living human cardiac catheterization was performed in 1929 by Dr. Werner Forssmann at age 25 and shared the 1956 Nobel Prize in Medicine Proper cardiac diagnosis and disease management relies on accurate hemodynamics Adequate flushing of catheters, avoidance of bubbles and equipment calibration (transducer placed at the mid-chest level) Underdampening – vigorous catheter movement or air bubble oscillation produces artifact in peaks and dips of the pressure waveform Overdampening – catheter kink or blood, contrast media or air in catheter can result in reduced pressure transmission. Figure SEQ Figure \* ARABIC 1: Left ventricle Pressure waveform (a) underdampening, (b) overdampening, and (c) normal. Underdampening of pressure waveforms results when either excessive catheter movement or air bubble oscillations produce artifacts in peaks and dips of the pressure waveform, with falsely elevated systolic pressure. Catheter kink or blood, contrast media, or air in the catheter can result in red...