Cardiac Catheterization

Question 1

Left-sided catheterization is accomplished via?

Answer 1

Via arterial puncture in the femoral or brachial artery

Question 2

Left-sided catheterization is typically used on what procedures?

Answer 2

Aortography, coronary and coronary bypass graft angiography, ventriculography, and evaluation for patent ductus arteriosus

Question 3

Right-sided catherization is typically accomplished by?

Answer 3

By venous puncture in the femoral or brachiocephalic vein

Question 4

Right-sided catheterization is used for what procedures?

Answer 4

For pulmonary angiography, catheterisation of RA and RV, or evaluation of shunt lesions such as atrial septal defect

Question 5

What is the normal right atrial pressure and oxygen saturation?

Answer 5

2 to 5 mm Hg and 65 to 75% oxygen saturation

Question 6

Elevated right atrial pressures are seen in what cases?

Answer 6

Right heart failure, decreased compliance, and tricuspid valve disease

Question 7

A 7% or greater increase in the saturation from the IVC to RA is considered evidence of what case?

Answer 7

A left-to-right shunt (ASD)

Question 8

What is the normal right ventricular pressure and oxygen saturation?

Answer 8

25 systolic and 0 to 5 diastolic mm Hg.

Saturation should be the same as the right atrium (65-75)

Question 9

Elevated systolic and diastolic pressure of the right ventricle are seen in what cases?

Answer 9

Elevated systolic pressure = pulmonary hypertension, pulmonic valve stenosis, and congenital heart lesions such as transposition and truncus arteriosus

Increase diastolic pressure = right heart failure

Question 10

A 5% increase in saturation from RA to RV suggest what disease?

Answer 10

VSD

Question 11

What is the normal pulmomary arterial pressures?

Answer 11

25 systolic and 10 diastolic mm Hg, with a mean PA pressure of 15 mm Hg

Question 12

A significant pressure gradient (> 10 mm Hg) across the pulmonary valve implies what pathology?

Answer 12

Pulmonic valve stenosis

Question 13

Pulmonary arterial saturation should be approximately the same as the right ventricular saturation, with how many % difference should be considered significant for a shunt lesion?

Answer 13

3%

Question 14

What is the normal pulmonary capillary wedge pressure?

Answer 14

2 to 8 mm Hg and approximates the left atrial pressure unless there is evidence of pulmonary venous obstruction

Question 15

Elevations in the left atrial or wedge pressure are usually seen in what cases?

Answer 15

Mitral stenosis or left-sided congestive heart failure

Question 16

Norma left atrial saturation is approximately how many percent?

Answer 16

94%

A decrease greater than 5% implies right-to-left shunt

Question 17

What is the normal left ventricular pressure?

Answer 17

Apporximately 120 systolic and 0 to 5 diastolic mm Hg

Question 18

What are the disease associated with decreased or increased left ventricular pressure?

Answer 18

Decreased systolic = shock and congestive heart failure
Elevated systolic = systemic hypertension or outlet obstruction
Increased diastolic = congestive heart failure

Question 19

Pressure gradients of mild, moderate, and severe aortic stenosis.

Answer 19

Pressure gradient across the aortic valve

Mild = greater than 25 mm Hg
Moderate = 40 to 50 mm Hg
Severe = exceeding 80 mm Hg

Question 20

Pulmonic stenosis is considered significant if the right ventricular systolic pressure exceeds how many mm Hg?

Answer 20

70 mm Hg

Question 21

PA hypertension is defined as a mean PA pressure of more than how many mm Hg?

Answer 21

25 mm Hg