Cardiac Catheterization-Hemodynamics

Created by Kathryne_Ross 

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What is hemodynamics?

The study of forces related to blood circulation in the body.

Examples of things studied in hemodynamics . . .

Blood pressure, arterial, venous

Hemodynamics is used to evaluate ...

Heart function

Pressures are measured in a ...

Right heart cath

Pressures can be measured two ways. Those are ____ and _____.

Invasive, non-invasive

To read pressures, we have ____signals and ____ signals.

Input, output

Pressure exerted via the fluid in the catheter is the _____. This is connected to a transducer or ___ ____ that changes the signal. This results in an electrical expression, ___, of the force exerted and is displayed as ___.

Input, wheatstone bridge, output, waveforms

CVP or ____ _____ ______ i the pressure within the SVC. It reflects the amount of blood ____ to the hrart. It is often read via catheter inserted into the ____ vein.

Central venous pressure, returning, subclavian

Because there are no valves between the RA and SVC or IVC, the CVP and pressure of the RA should be ___.

The same

RA pressures are often reported as a ___ pressure because of the small difference between ___ and ___ measurements.

Mean, systolic, diastolic

RA pressure is expressed in a waveform represented by the letters

a, c, x, v, y

The mean pressure of the RA is ___ and the O2 saturation is ____.

2-5 mmHg, 65-80%

Elevated RA pressures could mean:

RV failure, tricuspid disease (TR or TS), cardiac tamponade, pulmonary hypertension, chronic LV failure, Volume overload

The pressure of the ___ ___ is higher than that of the RA.

Right ventricle

RV pressures are expressed as ___, ___, and ___ ___. Those number ranges are ___, ___, and ___. The O2 saturation is ___.

Systolic, diastolic, end diastolic, 15-28 mmHg, 0-8 mmHg, 2-6 mmHg, 65-80%

High RV pressures can indicate

Pulmonary congestion, pulmonary HTN, PV stenosis, L-R shunt, COPD, peripheral PA stenosis

High RV-EDP can indicate

Valve insufficiency, fibrosis, pericarditis, tamponade

During ventricular ____ the blood that is in the PA is distributed throughout the ___ ____.

Diastole, pulmonary vasculature

In the PA, the ranges for systolic, diastolic, and mean pressure are . . . And o2 sat is:

15-18 mmHg, 5-16 mmHg, 10-22 mmHg, 65-80%

Elevated pressures in the PA can indicate:

Pulmonary emboli, mitral valve stenosis, COPD, pulmonary HTN, LV failure, PA stenosis

Low PA pressures can indicate:

Pulmonary valve stenosis (insufficiency)

PCWP or PAWP pressures are obtained using a ____-____ ____ floated in the ___ ___.

Swan-Ganz catheter, pulmonary artery

The PWCP allows for indirect pressure measurement of the ___ ____.

Left atrium

Normal ranges for PWCP are:

Mean- 6-14mmHg
A wave- 9-18 mmHg
V wave- 9-18 mmHg
O2 sat- 95-100%

Low PWCP can indicate

Hypovolemia

High PWCP can indicate

LV failure, mitral stenosis, tamponade, hypervolemia, ischemia, cardiomyopathy, valve disease

Left ventricular pressure is measured ___ with a catheter placed in the ___ ___.

Directly, left ventricle

Normal LV pressure measurements are:

Systolic 90-140 mmHg
End diastolic 4-12 mmHg
O2 95-100%

AO pressures will vary depending on _____.

Location

Normal values for the AO are

120/80

How is mean pressure calculated?

Mean= systolic + (2 x diastolic)
-------------------------------
3

Gradients are pressure differences caused by an ______. They occur with ___ or ____ ____ ____.

Obstruction, stenosis, valve function problem

Gradient=

Blood flow x resistance

Calculation of the size of the opening of a valve helps ...

Determine the level of stenosis in the valve

There are 2 primary methods to calculate AoV and MV stenosis. These are . . .

Gorlin formula and Haaki formula

The ___ formula is the most accurate way to calculate blood flow.

Gorlin

The ____ formula is a shortcut method for determining blood flow.

Haaki

Haaki formula=

Cardiac output/ square root of pressure gradient

Cardiac output =

Normal range

SV x HR

4-8 LPM

Cardiac index is CO that takes into account ____. Its formula is _____ or ____.

BSA, CO/BSA, (SV x HR)/BSA

There are 3 primary ways to obtain cardiac output:
All three are _____ ______ calculations

Fick formula, thermodilution, angiographic, forward motion

The ____ formula is based on estimated oxygen consumption and blood saturations.

Fick

Rquired parameters for Fick calculations are:

Hgb, age, sex, height, weight

______ calculates CO by measuring temperature changes detected by a thermistor.

Thermodilution

SV=

LVEDV-LVESV

The angiographic method uses ____ to measure CO

Contrast

Regurgitation fraction=

SV (angiographic) - SV (Fick or Thermo)/Angiographic SV

shunts can be either _-_ or _-_. They can be caused by congenital defect: ___, ___, ___, ___

L-R, R-L, ASD, PFO, VSD, anomalous venous return

Severity of a shunt is determined by:

Blood saturation tests and cardiac output/indexes

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