CFRN Flashcards
What is CVP
Right atrial pressure/Right sided pre-load measurement
What causes increase in CVP
Left systolic failure, Volume overload, Pulmonary Hypertension, Cardiac Tamponade
What is normal right ventricle pressure
Systolic 20-30, Diastolic 0-5
What causes high RVP
Right Ventricular Failure, Chronic CHF, Pulmonary Hypertension, Hypoxemia, Cardiac Tamponade
Right Ventricular Waveform
Tall upstroke is ventricular systole passive filling. Anacrotic notch = atrial kick. Notch on left side of waveform.
If CVP migrates into RV
Inflate balloon, pull back until CVP waveform is present
What are normal Pulmonary Artery Pressures
PAS 15-25, PAD 8-15.
What does PA pressure measure
Measures RV systolic pressure, indirectly measures left ventricular end diastolic pressure
What causes increase in pulmonary artery pressure
Fluid overload, Atrial and Ventricular defects, Mitral valve regurgitation/stenosis, LV failure
What is normal PCWP
8-12
Right Failure
High CVP, Low PCWP/PAD
Dicrotic notch on right side of PA waveform
Closure of pulmonic valve closure
PCWP measures
Left atrial preload, indirect left ventricular end diastolic pressure
Increased PCWP
LV failure, Fluid overload, Cardiac Tamponade
What is overdampened waveform
Waveform slowly returns to baseline caused by cathether kink, tip of cathether against wall, high pressure in bag
What is underdampened waveform
Many oscillations before baseline. Air in system, altitude change, low pressure in bag
Large V wave in PA waveform and high PA pressure
Severe mitral regurgitation
Coronary Perfusion Pressure
Diastolic BP- PAWP
Pulmonary artery pressure reflects
right and left sided heart pressures
Systemic Vascular Resistance
Measures afterload of left side of heart
Pulmonary Vascular Resistance
Measures afterload right side of heart
Stroke Volume
Amount of blood ejected with each heart beat from the ventricles during systole
Atrial Waveforms
“Filling pressures” and include right and left atrial pressures
C wave
Rise in atrial pressure when AV valves close and bulge upward into atrium following valve closure
V wave
Rise in atrial pressure as it refills during ventricular contraction
A wave
Coincides with PR interval on EKG
C wave
Coincides with mid-late QRS on EKG
V wave
Appears immediately after peak of T wave in right pressure
Y descent
Downslope of V wave, decline in atrial pressure indicates atrial emptying
X descent
Downslope of A wave, decline in atrial pressure, indicates atrial relaxation
Isovolumetric contraction
When all 4 heart valves are closed due to depolarization.