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Comparing a PA waveform to a simultaneous ECG tracing: Diastole is measured after the QRS complex
PA= 36/22, PCW = 10/12/10. What abnormality could cause such a gradient? COPD
For the last hour your patient has been in normal sinus rhythm with a PA pressure of 25/15/18. Now she has frequent PVC's and a pressure reading of 25/0/8. What should you consider the cause? Swan has pulled back to RV position
What indicates the opening of the semilunar valves? Anacrotic notch
PA pressures vary with: the respiratory cycle
What cardiac catheterization waveform would represent pulmonic stenosis? systolic gradient between PA and RV
What is a sign of PA hypertension on the waveform? late dicrotic notch in PA due to pushing blood against resistance. it takes longer to close the valve.
What pressures would you need to see in order to determine constrictive pericarditis RA and RV
What would the pressure tracing in the RV and PA look like with pulmonic stenosis? RV pressure up, PA pressure, down
In pulmonary capillary wedge tracings the: V- wave is due to atrial filling during ventricular contraction
PC wedge pressure is measured during what phase of the respiratory cycle? end expiratory
Under normal conditions PCW pressures should approximate what three other pressures? LA mean, LV edp, PA diastolic
Large V waves in the PCW waveform indicate what valve disorder? mitral regurgitation
Normally the END diastolic gradient between the PA pressure and the PAWP(wedge) is small (1-4mmHg). What two conditions increase this gradient? COPD and high cardiac output
Considering all types of shock, only one results in an elevated wedge pressure: It is: cardiogenic shock (LV failure)
Large "a" waves in the PCW waveform indicate what valve disorder? mitral stenosis
The "M" or "W" sign in the RA waveform is caused by the rapid X and y descents during atrial and ventricular emptying. This is consistent with: cardiac tamponade, normal pressures, constrictive pericarditis, HOCM, RV failure Constrictive Pericarditis
What is likely when you see respiratory respiration where you're not supposed to see it? tamponade
The paradoxical increase in RA pressure during in cases of constrictive pericarditis is called: Kussmaul's sign (respiratory variation
Where is diastolic dip and plateau seen and what does it resemble? ventricles, a square root sign
the characteristic feature of the ventricular pressure waveforms in either restrictive cardiomyopathy and constrictive pericarditis is the: Square root sign or dip and plateau
Regarding the timing of RA pressure waves with the ECG tracing: A-waves follow just after the P wave
To measure the RA mean pressure: Measure the highest and lowest points of the wave and average
Normal mean RA pressure should not exceed: 8mmHg
RA= 12/10/8, RV = 24/2/3, PA = 24/14. What abnormality could cause such a gradient? Tricuspid stenosis
Post PTCA your patient's Swan readings are CVP= 28, PA = 40/22, PCW = 28. You should suspect: Cardiac tamponade
The a wave in the RA tracing represents atrial contraction
The V wave in the RA tracing represents Ventricular contraction during atrial filling
Your patient had an RV pressure of 50/2/10 and PA pressures of 20/12. What abnormality could cause such a gradient? pulmonic stenosis
RV failure is identified by: elevated EDP
Kussmal's sign represents: respiratory variation in the RA because it's being crushed (tamponade)
An interventricular gradient is present in infundibular stenosis
What hemodynamic sign is characteristic of pulmonic stenosis? systolic gradient in PA to RV pullback
What hemodynamic sign is representative of restrictive cardiomyopathy and constrictive pericarditis? square root sign in the RV diastolic pressure
What are some conditions that can cause RV systolic pressure to be elevated? COPD, LV Failue, VSD, Primary pulmonary hypertension
What would the PCW look like in Mitral stenosis? high, along with a big diastolic gradient
Hypertrophic obstructive cardiomyopathy sometimes involves both ventricles. If it affected the RV side of the septum as well, what hemodynamic anomaly would you be looking for? Intraventricular gradient between RV apex and RV outflow tract
Your patient shows the following pressures: PA= 35/20/25; RV = 35/2/15; RA = 23/22/15 RV failure
In a left to right ASD, what is the effect on the RV pressures? they: increase
What can cause the square root sign in an RV tracing? noncompliant myocardium resisting passive filling
In cardiac tamponade the RV free wall collapses due to accumulated fluid in the pericardial space. What is the effect on RV pressure? RV diastole rises and equalizes with PA diasole
Patient developed pulmonary embolus, what hemodynamic finding is most likely? PAD exceeds wedge pressure
Acute septal MI with VSD what hemodynamic finding is most likely? RV and PA systolic pressures rise
When the fluoroscopic C arm is angled into a cardiac view so that the X-rays exit from the patient's left abdominal area, what angiographic view is this? Caudal LAO
Which artery is sometimes seen branching directly from the aorta? The: Conus
Pulseless pt in vtach deliver an unsynchronized shock
Mag sulfate - recommended dose: 1 to 2 g diluted in 10ml slow iv push
Created by: ICVT2b