Hemodynamics/ Cath/ Contrast Flashcards
pulmonary hemodynamics
- low pressure
- low O2 content in artery
- low resistance
- RV wall is thin
systemic hemodynamics
- high pressure
- high resistance
- LV wall is thick
- high O2 content in artery
pulmonary components
- pulmonary artery
- arteries
- capillaries
- veins
systemic components
- aorta
- arteries
- arterioles
- capillaries
- veinules
- veins
- vena cava
arteries
- elastic ,thick walled blood vessels
- expand during systole then recoil during diastole to keep blood moving forward
veins
- thin walled blood vessels that collapse easy
- able to expand rapidly to accommodate large volumes of blood
- contain the majority of circulating blood.
blood
- 54% of blood is plasma
- 45% of blood is red blood cells( erythrocytes)
- 1% of blood is white blood cells (leukocytes) and platelets (thrombocytes)
normal pressures for aorta
120/80
normal pressures for PCW
10
normal pressures for pulmonary artery
25/10
normal pressures for right atrium
8/5
normal pressures for right ventricle
20/0/5
normal pressures for left atrium
10/12
normal pressures for left ventricle
120/0/12
normal atrial pressures are about ____ in the RA and ___ in the LA. other than that the right sided pressures are approx. ___ of the left sided pressures.
RA= 6mmHg
LA=10mmHg
right sided pressures are apox1/5th the left sided pressures
what is the normal pressures in the pulmonary artery
25/10
oxygenated blood
- 95% saturated (pink blood)
- starts in the pulmonary veins and continues to the end of the systemic arteries
deoxygenated blood
- 75% saturated (blue blood)
- starts in the systemic veins and continues tot he pulmonary arteries
O2 saturation for aorta, LA, and LV
95%
O2 saturation for PA, RA, and RV
75%
where is the O2 saturation the lowest?
coronary sinus (usually around 40%)
O2 saturation in pulmonary veins
95%
O2 saturation in pulmonary arteries
75%
angiography
contrast medium injected while cineangiography film records results (vessel narrowing, regurg, shunts, EF).
LV agiogram is also called
- ventriculography
- selective angiography
- angiocardiography
best cathn technique for LV function
LV angiogram
cardiac output (two types)
- flick method
2. angiographic technique
flick method
measures O2 consumption divided by the difference in O2 content between arterial and pulmonary system
angiographic technique
multiples the stroke volume by the heart rate
oximetry
measures O2 saturation in various chambers (able to ect shunts by changes in O2 saturation)
shunt size is calculated by
the difference between pulmonary and systemic blood flow
acqure the lt atrial pressure during the rt heart cath via the
pulmonary capillary wedge pressure or the transeptal approach
obtain the PCW/PCWP when
a flow directed ballon tip catheter (aka swan-ganz or rt heart cath) is passed from the RV into the pulmonary artery and allowed to float as far as it will go until its wedge into a pulmonary end artery
The pressure distal to the wedge when obtaining the PCW/PCWP is an approx.
lt atrial pressure
the pressure recorded when the ballon is deflated while trying to obtain PCW/PCWP is
the pulmonary artery pressure
what is the pulmonary capillary wedge measuring
lLa pressure
to determine AS where are catheters placed?
- one in the LV and one in the AO
- one in the LV and “pulled back” across the AoV
- one catheter with two separate sensors.
high gain destroys
resolution
low frequency (2.5MHz) = high frequency (4.0MHz)=
low= better penetration high= better resolution
fundamental imaging
transmit and receive at the same time
harmonic imaging
transmit at one frequency and receive at the 2nd harmonic (twice the transmit frequency
tissue harmonic imaging results in
thicker valve leaflets
apical swirling of echo contrast for LVO is caused by
high MI
Trans pulmonary contrast agents
- various companies make echo contrast agents
- bubbles are smaller than red blood cells
- cross the pulmonary circuit
trans pulmonary contrast agents are used for
left ventricular opacification when two or more contiguous segments are not seen from any apical view
trans pulmonary contrast agents has various methods for infusion/administration _______ and machine settings for optial imaging______
infusion/admin= 1. bolus
2. continuopus infusion
optial imaging
- low MI
- focus
- harmonics
swirling in the LV apex is caused by
the MI being too high or the amount of contrast injected is too low
attenuation of contrast is caused by
the amount of contrast injected is too high or was injected too fast
