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Hemodynamics

QuestionAnswer
Wave forms: Atria Sine wave
Wave forms: Ventricle Square wave
Wave forms: Arteries Triangle wave
Wave forms: Pressure spike Impulse wave
Hemodynamic sign associated with cardiac tamponade? Arterial Pulsus Paradoxus
LV -edp readings are normally the same as? Pulmonary capillary wedge pressure
PAW measurement that approximately matches LV-edp: Mean between "a" wave and "x" wave of PAW
In what condition is the PAWP usually equal to the LV-edp or within 4 mmHg: Acute respiratory failure
The wedge pressure best reflects LA pressure when? The balloon is positioned in the dependent lung zone
How is PAW pressure and transseptal LA pressures normally differ? PAW is delayed and slightly damped
When measuring CFR or FFR what drug is safest and shortest acting to induce coronary response? Adenosine
CFR measures? Velocity
FFR measures? Flow
Formula for FFR? Pd/Pa
When measuring FFR, what does the pressure waveform look like? Ventricularization pattern
To pullback a pressure wire while recording pressures through a diffusely diseased vessel start with? 140 IV adenosine
What would best identify thrombus from soft plaque? IVUS or Angioscopy Angioscopy
What makes OCT better than IVUS? Increased resolution
Prior to inserting IVUS imaging catheter into coronary artery. Assure full anticoagulation and? Inject 100-300 ug of nitro
What adult cases commonly use ICE? Transeptal and PFO closures
How many ICE views are their? 4
CI: Amount of blood pumped by the heart adjusted to body size
LVMP: Quantitative angiographic CO
TDCO: Indicator dilution CO using cooled saline
Fick CO: Average Pulmonary CO measured via, oxygen extraction
Parameters like "stroke index" are corrected for patients? Body Surface Area
3 measurements that can be adjusted to patients body size (indexed) EDV index / Cardiac index / Valve area
Average CI: reclining 7 year old 4.5 L
Average CI: Standing 7 year old 3.5 L
Average CI: reclining 70 year old 2.5 L
Average CI Standing 70 year old 2.0 L
The Normal O2 Content of blood in the Left heart is? 18-22 Vol%
For Fick CO, where should the arterial blood sample be taken? Any systemic artery
What blood gas parameter will be reduced in an anemic patient? CaO2 Vol%
Normal O2 capacity of venous or arterial blood is? 20 Vol%
Considered the "Gold Standard" measurement: Fick CO (is the average forward flow through the lungs)
Factors that affect CO Size / Position / Age
Which Right heart O2 saturation is normally the highest? IVC
Best mixed blood is from what area of the heart? The PA
The actual amount of O2 carried in blood is defined as? O2 Content
The normal O2 content of blood in the left heart is? 18-22 vol%
What is the average resting a-v O2 difference in resting adults? 4-5 vol % or 40-50 ml/L
What blood gas parameter will be reduced in an anemic patient? CaO2
O2 Saturation is defined as? O2 content / O2 capacity x 100%
SvO2 is an indicator of? Tissue oxygen supply/ oxygen demand balance
Normal range for SvO2 is? 65 - 77%
What is impending deterioration of a pt. with a fiberoptic SvO2 PA catheter? When the SvO2 drops below 60% or drops >10% over 3-5 minutes
What is the most common cause of decrease in SvO2? Hypoperfusion (Decreased TDCO)
What is the percent of Oxygen in ambient air? 21%
Standard barometric pressure at sea level? 760 mmHg
For calculation of oxygen consumption, the minute ventilation must be adjusted for? Standard temp and pressure dry (STPD)
Average oxygen consumption in the normal male? 200-300 ml/min
Before taking FICK CO blood samples, take the pt. off oxygen for? 10-15 mins
In cyanotic shunts there is a _______ in O2 saturation on the___ side of the heart? Step down / Left
In children with ASD the best sample is taken from the? SVC
When calculating the amount of shunt in a L to R VSD, the best mixed systemic venous blood sample is in? Right Atrium
The formula (1 IVC + 3 SVC) / 4 is used to estimate? systemic venous O2 saturation in L-R ASD
Amount of blood ejected out the LV with each systole: SV
Total amount of blood pumped by the LV per minute: LVMF
Maximum volume of blood in the ventricle when filled: EDV
Percentage of blood pumped by LV per minute: EF
Net forward amount of blood pumped by LV per minute: CO
Minimum volume of blood in the ventricular chamber: ESV
Amount of blood regurgitating (reversed flow) RV
Ratio of regurgitation to total LV flow: RF
The cutoff between normal and abnormal EF is? 50-55%
All CO's should be equal (FICK = TDCO = LVMF) except if theres? Valvular regurgitation
Kennedy/Dodge method simplies the shape of the LV chamber to that of a? Ellipse of rotaion
The LV is best viewed in what angio graphic shot? 30 RAO
Where should heart thickness be measured for most accurate LV mass measurement? Anterior wall where epicardium is best visible
What is the specific gravity of myocardium: 1.05
What is the normal thickness of the heart? 1.1
Total stroke volume SV: Cine EDV - Cine ESV
Forward stroke volume: FICK CO/HR
Regurgitant Volume: Total SV - Forward SV
Ejection Fraction: Total SV/EDV
Reguritant Fraction: Regurgitant volume/Total SV
Increases in SVR chiefly cause? Increase LV afterload
A cyanotic cardiac shunt implies a: High pulmonary vascular resistance (PVR)
Created by: IdAhOmEyEr