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Hemodynamics
| Question | Answer |
|---|---|
| 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
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