Heart Chamber Pressures

Diagnosis of heart diseases has been revolutionised after the discovery of cardiac catheterisation. It simply works wonder after proper pressure measurement of all cardiac chambers.

Interventional cardiologist cam cure almost half of the heart diseases beginning from congenital cardiac issues to the adult percutaneous coronary intervention by stent placement. Now percutaneous valve placement and pemnanet pacemaker implantation has kept to-be-dead people alive.

Cardiac catheterisation can be right heart catheterisation or left heart catheterisation depending on the need of suspicious diagnosis or both if required, and in complex cases it needs both.

Coronary angiography after an ECG changes can clearly diagnose the disease with aortogram with root shot of dye in aorta.

To keep the chapter short and brief almost all cardiac condition can be diagnosed with cardiac catheterisation. Pressure tracing is an important part of it with consideration of saturation in congenital cases.

Elevated RA pressure:

  • Tricuspid stenosis – large ‘a’ wave
  • Tricuspid regurgitation- large ‘v’ wave
  • RV dysfunction-pulmonary hypertension, RV infarction
  • Constrictive pericarditis
  • Tamponade
  • Restrictive disease

Elevated RV pressure:

  • RV dysfunction ( pulmonary hypertension, RV infarct)
  • Constrictive pericarditis ( square root sign; rapid x and y descent)
  • Restrictive disease
  • Cardiac tamponade ( absent ‘y’ descent)

Elevated PA pressure :

  • Mitral stenosis / Regurgitation
  • LV systolic or diastolic dysfunction ( ischaemic, dilated cardiomyopathy, aortic stenosis/regurgitation)
  • Pulmonary hypertension of other etiologies
  • Constrictive pericarditis / tamponade / restrictive disease

Elevated PCW pressure:

  • Mitral stenosis ( large ‘a’ wave if sinus rhythm)
  • Mitral regurgitation ( large ‘v’ wave)
  • LV systolic or diastolic dysfunction ( ischemic, dilated cardiomyopathy, aortic stenosis/regurgitation)
  • Constrictive pericarditis/tamponade

Elevated LVEDP:

  • LV systolic or diastolic dysfunction ( ischemic, dilated cardiomyopathy, aortic stenosis/regurgitation)
  • Constrictive pericarditis/tamponade.

So long as we manage or play safe with pressures and numbers we are safe and sure of what we treat.

Author: what2talk

Myself, Dr. Sibashankar Kar, doing my Cardiothoracic Surgery in Sir Ganga Ram Hospital. The purpose I have made this website is to discuss on the topics of cardiology and cardiac surgery as a whole with their complexities.

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