Module 1 - LHC Hemodynamics

The normal mean pressure for the pulmonary artery is ____

10-20 mm Hg.

PA mean pressure is

10-20 mmHg

average RV pressure

25/5

normal RA O2 sat

75%

average aortic mean pressure is what

70-90 mmhg

In PA pressure what does the dicrotic notch signify

the closure of the pulmonicvalve.

The a wave in atrial pressure tracings represents

atrial contraction

The c wave in atrial pressure tracings represents bulging of the _____ during early ventricular systole

TV/MV

positive pressure spike that occurs during the early phase of ventricular contraction, caused by the closed tricuspid valve bulging into the atrium as the right ventricle begins to contract

TEMP BACK PRESSURE

The x descent in atrial pressure tracings represents ____ of the atrium as the AV valve moves downward

atrial relaxation

The v wave in atrial pressure tracings represents passive ____ of the atrium while the AV valve is closed

FILLING

The y descent in atrial pressure tracings represents _____ of the atrium as blood flows into the ventricle.

and opening of the ______ valve

represents emptying of the atrium

opening of the tricuspid valve

In a fib the absence of coordinated atrial contraction leads to loss of the ___ wave

In the ECG the **** wave is absent due to fibrillation

A wave for pressure waveform

p wave for ECG

Tricuspind regurg causes an exaggerated ____ wave due to backflow of blood into the RA

V wave

In the PA waveform the dicrotic notch reflects closure of what valve

pulmonary valve

What is going on here

Mitral stenosis.

Blues represent the diastolic pressure gradient due to stenotic valve

elevated LA pressure due to backup in LA

Good representation for increased preload

- The most common cause of mitral stenosis is prior ____ ______ (50%- 70% of patients with symptoms)

rheumatic fever

left atrial (LA) waveform, the A wave typically occurs just ____ the ____

Before the QRS

in the right atrial (RA) waveform, the ***** (first wave) typically follows the *** on the electrocardiogram (ECG)

A wave typically folllows the p wave

Cardiac tamponade leads to blunted ____ and _____ due to impaired atrial filling and emptying

X & Y

What is normal LVEDP

Normal left ventricular end-diastolic pressure (LVEDP) is typically between 4 and 12 mmHg, indicating proper filling pressure in the left ventricle.

The A wave represents __

The A wave represents (1) atrial contraction;

LVEDP greater than 12 mmHg usually suggests_______________, often seen in______ or ____ dysfunction.

LVEDP greater than 12 mmHg usually suggests increased left ventricular filling pressure, often seen in heart failure or LV dysfunction.

The dicrotic notch reflects the ___ during the cardiac cycle, marking the end of ventricular systole.

The dicrotic notch reflects the (1) closure of the pulmonic valve.

EDP stands for ___ , which is caused by the ___________ after filling, influencing the stroke volume.

EDP stands for (1) End Diastolic Pressure, which is caused by (2) blood volume in the ventricle after filling.

Ficks principle measures how an organ takes in or releases oxygen based on the differences in __________

oxygen concentration levels

A Stroke Volume (SV) represents the volume of blood ___ from the heart with each ___ , contributing to overall cardiac performance.

A Stroke Volume (SV) represents the volume of blood (1) ejected from the heart with each (2) contraction.

The normal percentage of ejection fraction is ___, indicating healthy left ventricular function and overall cardiac health.

The normal percentage of ejection fraction is (1) 50% - 70%.

Factors that increase preload include ___ circulating volume & _(valve problem)__ and ___ , leading to enhanced cardiac filling.

Factors that increase preload include (1) increased circulating volume, (2) mitral regurgitation (build up in the retro side), and (3) heart failure. (reduced CO so body activates compensation mechanisms like RAAS that lead to fluid overload)

Increased afterload on the heart would be indicated by ___ (1) and increased ___ ), making it harder for the heart to pump efficiently.

Increased afterload on the heart would be indicated by (1) hypertension and increased (2) systemic vascular resistance (SVR).

The normal systolic pressure range for the aorta is ___ (1) between 100 and 140 mm Hg, which is critical for ensuring adequate systemic perfusion.

The normal systolic pressure range for the aorta is (1) 100 - 140 mm Hg.

The 'V' wave corresponds to _____ to the __ while the ___valves is________ during the cardiac cycle.

The 'V' wave corresponds to (1) venous return to the atrium while the (2) AV valve is closed.

Isovolumetric contraction is characterized by a significant rise in ___ without a change in __ ___ until the ___ valves opens for ejection.

Isovolumetric contraction is characterized by (1) a rise in ventricular pressure without a change in volume until the (2) semilunar valve opens.

Normal pulmonary artery pressures are characterized by a systolic range of ___ and an end-diastolic range of ___ , reflecting healthy right heart function.

Normal pulmonary artery pressures are characterized by a systolic range of (1) 20-40 mmHg and an end-diastolic range of (2) 8-12 mmHg.

25/10

The formula for mean arterial pressure (MAP) consists of the components: ___ (1) MAP = DBP + (SBP - DBP) / 3, providing insight into overall arterial pressure during the cardiac cycle.

The formula for mean arterial pressure (MAP) consists of the components: (1) MAP = DBP + (SBP - DBP) / 3.

A tall 'V' wave in mitral regurgitation suggests ___ which can indicate worsening heart function or volume overload states.

A tall 'V' wave in mitral regurgitation suggests (1) hypervolemia and congestion.

Increased pulmonary capillary wedge pressure (PCWP) may indicate ___ or ___ serving as a marker for elevated left atrial pressure.

Increased pulmonary capillary wedge pressure (PCWP) may indicate (1) left ventricular failure or (2) mitral stenosis.

The relationship between stroke volume and ejection fraction is that ejection fraction represents the percentage of **** **** in relation to *** **** volume.

The relationship between stroke volume and ejection fraction is that ejection fraction represents the percentage of (1) stroke volume in relation to (2) end-diastolic volume.

What is occurring at step 1?

What is occurring at step 2?

What is occurring at step 3?

What is occurring at step 4?

dicrotic notch on an arterial pressure waveform represents the ****** of the **** valve

closure of the aortic valve

average RV EDP is

5 mmHg

at what point is EDP taken in the LV

during the diastolic phase of the cardiac cycle, specifically when the left ventricle is at its fullest. Just about when wave reflects up.

average RV pressures

25/5

average LV EDP

8 or 5-12 mmHg

Normal LV pressures

128/10

The difference between diastolic pressure and EDP is diastolic is taken at the ***** ****** in the LV during diastole

Lowest pressure

The difference between diastolic pressure and EDP is EDP is at the end of diastole taken just before the *** *** *****

ventricle: lv and rv whats the answer

just before the outflow valve opens; primarily ventricles;

LV just before ao valve opens

RV b4 PV opens

just before isovolumetric contraction begins

Pulse pressure is found by the **** between *** and ***** pressure

difference between the systolic and diastolic pressure.

PP = *** - ****

PP = SYSTOLIC - DIASTOLIC PRESSURE

map = *** + 2*** / *

SBP + 2DBP / 3

MAP for PA is typically

10-20 mmHg

the PA peak systolic range is

20-40 mmHg

the PA diastolic range is *** mmHg

8-12 mmHg

PA sys/diast pressure is typically

20-40/8-12 mmHg

2 potential causes for ^ PCW pressure

LV failure

MS

LVEDP is a good indicator for ***** heart *****

overall heart funciton

5 causes for ^ RA press

PHTN

TR

RVMI

PE

L>R SHUNT

^ RV pressure

PHTN

PVALVESTENOSIS

PE

L>R SHUNT

^ PA PRESS

PHTN

COPD

MS

PE

L>R SHUNT

Range for Ao systole pressure

100-140 mmHg

Range for Ao diastolic pressure

60-80 mmHgThe normal range for aortic diastolic pressure is typically between 60 and 80 mmHg, indicating the pressure in the aorta during the heart's relaxation phase.

MAP for Ao

70 - 90 mmHg

what is occurring at these blanks and what do they signify

signify.. start of what cycle

and the end of what

indicate the closure of valve signifying the end of systole and the beginning of diastole

the dicrotic notch displays the closure of the aortic valve and indicates the beginning of the **** ****

diastolic phase

what is occurring in this arterial waveform

overdamped

Whats occurring in this

What is occurring in this waveform

Ventricularization from cto of CA and the ventricle muscle sucks the catheter

50-70% EF signify what

normal function

what percentage is considered high EF

70%

EF is calculated by what equation

SV/EDV

SV is calculated by what equation

EDV - ESV

these 3 issues decrease preload

decreased circulating volume (dehydration, hypovolemia)

MS (narrow valve limits blood flow into LV)

asynchorny of a/v (torsads or pulse alternans) (decreased ventricular filling time, weak beats weat stroke volume, chaotic electrical activity leads to ineffecive ventricular contractions)

4 problems that increase preload

increased circulating volume

MR

HF

AR

Vasodilators do what to preload

decrease

vasoconstrictors do what to preload

increase preload

vasopressors do what to afterload

increases

vasopressors do what to BP

INCREASE by constrictive vessels

its in the name

vasodilators do what to afterlaod

decreases afterload

easiest way to assess afterload is measuring **

BP

Fick principle states that An organ absorbs or releases a substance depending on how much the substance changes in the blood as it passes through and how much blood is flowing through the organ

Fick principle states that An organ absorbs or releases a substance depending on how much the substance changes in the blood as it passes through and how much blood is flowing through the organ

CO(f) is calculated by

O2 CONSUMPTION / AVO2 DIFFERENCE

The principle states that the amount of oxygen consumed by the body is equal to the amount of oxygen delivered to the tissues, which can be used to estimate cardiac output.

by using oxygen consumption and the arteriovenous oxygen difference, providing an indirect measure of how efficiently the heart is pumping blood to deliver oxygen to tissues.

O2 consumptions / AVO2 difference solves for what

CO(f)

thermodilution injection require syringes fill with what amount

10ml for adults

Label this lumen

CO (angiographic) easy calculation

sv x hr

What does this indicate

Aortic stenosis

What does this indicate

What is occurring here

mitral stenosis

increased V wave in PCW signifies what valvular assessment

MR

normal RV sat

75%

normal RA pressure

2-6 mmHg

normal PA saturation

approximately 75%

normal PA pressure

20/8

normal lv sat

95%

normal la sat

95%

normal mean LA pressure

<8

normal RA mean

<5pressure in mmHg