Describe the Pressure Tracings

See the figure shown and answer the following questions

a)      Describe the aortic pressure tracing

b)      Describe normal Atrial pressure tracing

c)       Describe atrial pressure tracing in tricuspid regurgitation

d)      Effect of Tamponade on atrial pressure tracing

Answers:

a.      When aortic valve opens, pressure increases as blood flows into the aorta and reaches its maximum. Pressure falls as blood flows out of aorta and aortic valve closes

b.      " a " wave corresponds to right Atrial contraction and its peak demarcates the end of atrial systole. The " c " wave corresponds to right ventricular Contraction causing the tricuspid valve to bulge towards the RA. The " x " descent follows the 'a' wave and corresponds to atrial relaxation and rapid atrial filling due to low pressure. The " v " wave corresponds to Venous filling when the tricuspid valve is closed and venous pressure increases from venous return . The " y " descent corresponds to the rapid emptying of the atrium into the ventricle following the opening of the tricuspid valve.

c.       In TR there is increased right atrial pressure. Blunted x descent, prominent v wave, steep y descent and ventricularization of right atrial pressure.

d.      In cardiac tamponade there is diastolic equalization of pressures (RAP = RV diastolic pressure = PCWP). Increased right atrial pressure, right ventricular pressure and PCWP. Blunted y descent, prominent x descent on RA tracing

Reference:

Chapter 60, page 985 – Right Heart catheterization - Manual of Cardiovascular Medicine Fourth Edition - Brian P. Griffin MD FACC

Comments

Learn Echocardiography | Standard Protocol for Performing Comprehensive Echocardiogram | Explained with Images and Videos

If you are just starting to learn echocardiography, you will find that learning the full echo examination protocol will be immensely useful. The full protocol will provide a solid foundation for your career in echo. I personally found that once I could execute the standard protocol flawlessly, I was able to add and refine additional echo scanning skills while deepening my understanding of the purpose of each echo image. The echo protocol illustrated in this article is the same one we currently use for all our patients in the hospital and meets or exceeds the standards of American Society of Echocardiography (ASE) for an adult echocardiography examination. The protocol presented here is meant as a guideline and does not cover every aspect (such as off axis views) of an echo examination. Also other hospitals will probably have slight variations of this protocol depending on the lab's needs, which is normal. This article's main purpose is to provide a solid foundation for ...

𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚

𝘼𝙣𝙩𝙞𝙘𝙤𝙖𝙜𝙪𝙡𝙖𝙩𝙞𝙤𝙣 𝘼𝙛𝙩𝙚𝙧 𝙎𝙩𝙧𝙤𝙠𝙚 in Patient with AF and acute IS/TIA European Heart Association Guideline recommends: • 1 days after TIA • 3 days after mild stroke • 6 days after moderate stroke • 12 days after severe stroke Early anticoagulation can decrease a risk of recurrent stroke and embolic events but may increase a risk of secondary hemorrhagic transformation of brain infarcts. The 1-3-6-12-day rule is a known consensus with graded increase in delay of anticoagulation between 1 and 12 days after onset of ischemic stroke or transient ischemic attack(TIA), according to neurological severity based on European expert opinions. However, this rule might be somewhat later than currently used in a real-world practical setting.

What is Duke treadmill Score (DTS) and How to calculate it?

Watch this simple video on DTS calculation with example case: Commonly asked questions: How to Calculate Duke treadmill Score? What is DTS? How to risk stratify a patient with ETT (Exercise Tolerance Test)? #Cardiology #Non-Invasive risk Stratification

Dr. Usman's Cardiology Notes

Search This Blog