Cardiac Haemodynamics and Congenital Heart Disease Flashcards
What is the RV systolic pressure relative to systolic blood pressure?
roughly 1/3rd
What is wedge pressure a surrogate for?
LA pressure
What is Kussmaul’s sign?
inspiratory rise or lack of decline in RA pressure -> sign of constriction or RV ischaemia
How can a right heart catheter differentiate between constrictive pericarditis and restrictive cardiomyopathy?
enhanced ventricular interaction between LV and RV (pressures will move together in restrictive CM whereas will move differently in constrictive pericarditis
What is the definition of pulmonary hypertension?
mPAP > 25mmHg
What is the role of right heart catheter in pulmonary hypertension?
If wedge pressure is low/normal -> likely pulmonary vascular disease
If wedge pressure elevated -> likely secondary to left heart problem
How do you calculate pulmonary vascular resistance?
(mean PA pressure - wedge pressure)/cardiac output
What is normal pulmonary vascular resistance?
< 3-5
In which patients with pulmonary hypertension is pulmonary vasodilators not useful?
group 2 (left heart driven)
What is the most common form of ASD?
ostium secundum
When should ASD be closed?
symptoms, RV enlargement, Qp:Qs > 1.5
What is the commonest VSD?
membranous
When should VSD be closed?
symptoms, LV enlargement, Qp:Qs > 2:1
What is the main reason that PDA is closed?
endocarditis risk
Which patients with coarctation should be treated?
hypertension with gradient > 20mmHg
