In my previous post, I talked about a few important examples of cardiac lesion that give you abnormal oxygen saturation, today I am going to give you a few important cardiac lesions ( mainly valvular lesions ) that will give you abnormal pressure during cardiac catheterization.
Before we proceed , remember the normal cardiac pressure and oxygen saturation
Case 1: Mitral Stenosis
Look at the following cardiac catheterization result of a 40-year old lady
The diagnosis is mitral stenosis, you notice a few abnormal results here,
i) The catheter data show a gradient across the mitral valve (LA pressure – LV end diastolic pressure) .Remember that usually LA pressure equals to LV end systolic pressure; you can use the PCWP as a surrogate for LA pressure. In this case the gradient is 26-6 = 20 mmHg.
ii) There is also evidence of right ventricular hypertrophy, with markedly elevated RV pressures due to secondary pulmonary hypertension.
Case 2: Aortic Stenosis
A 65- year old lady was admitted to hospital due to syncopal attack, below is the cardiac catheterization results.
There is a systolic gradient of 81 mmHg across the aortic valve (LV systolic pressure – aortic systolic pressure), indicating severe aortic stenosis. Remember that hypertrophic cardiomyopathy also presents with a similar result, howeve, patients tend to be younger!
Case 3: Aortic regurgitation
This is an easy case, you notice a wide pulse pressure ( aorta :150/40), therefore the diagnosis is aortic regurgitation.
I would talk about a few more cases in my last post.
1 comment:
Excellent Effort..brillianT!
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