ECHO 2013 / Hemodynamics III Echo-Based Clinical Decision-Making Cases
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This is CW Doppler signal of AR What is the estimated LVEDP?
2 m/sec
1= 16 mmHg |
2= 42 mmHg |
3= 26 mmHg 4= |
Not able to estimate |
©2012 MFMER | 3225607-11
BP 152/42
AO
2
m/sec
LV
Calculation of LVEDP from AR Doppler Velocity
AR End-diastolic Pressure
= Aortic Diastolic Pressure - LVEDP
LVEDP
= Aortic Diastolic Pressure – ( AR EDV2 x 4)
©2012 MFMER | 3225607-12
CW Doppler from Pulmonary Valve
4 x PV velocity2 = PA pressure – RV pressure
©2012 MFMER | 3225607-13
The velocity indicated by arrows is related to ?
1. Conduction delay
2. Pulmonary HTN
3. Severe TR
4. RVH
©2012 MFMER | 3225607-14
How severe AR ?
PHT 260 ms
1= Mild 2= Moderate 3= Severe
©2012 MFMER | 3225607-15
Aortic Regurgitation
Pressure ½ time
end-diastolic AO-LV pressure difference
AO
LV
Decrease in AO pressure
Degree of AR
Systemic vasc. resist
Aortic compliance
Increase in LV pressure
Degree of AR
LV compliance
©2012 MFMER | 3225607-16
Increased LV filling pressure
AR
E 90 cm/s
PV
E’ 4 cm/s
©2012 MFMER | 3225607-17
Aortic Regurgitation
Pressure ½ time
end-diastolic AO-LV pressure difference
AO
LV
Decrease in AO pressure
Degree of AR Systemic vasc. resist Aortic compliance
Increase in LV pressure
Degree of AR
LV compliance
©2012 MFMER | 3225607-18
Mild AR and Myopathy
Short AR DT due to Increased LVDP
©2012 MFMER | 3225607-19
67 year old man with murmur and SOB
©2012 MFMER | 3225607-20