Hemodynamics "au contraire" despite diastolic flow reversal and angiographically severe aortic regurgitation.
One of the commonly used parameters for evaluating aortic regurgitation is the rate of pressure decay data obtained from echocardiographic evaluation or cardiac catheterization. The measurement of the rate of equalization of pressure between the aorta and the left ventricle and its utility in the setting of aortic insufficiency has been validated. Intuitively, the Doppler equivalent, pressure half-time, is inversely related to the severity of regurgitation. However, this is a phenomenon dependent on multiple variables including blood pressure, heart rate, compliance of the receiving chamber, effects of vasopressors and the volume status of the patient. We report a case of unique hemodynamics obtained during cardiac catheterization due to low filling pressures that was further confounded by elevated systemic vascular resistance in a critically ill patient with angiographically severe aortic regurgitation.
Department of Internal Medicine, Division of Cardiology, University of Cincinnati, 231 Albert Sabin Way ML 0542, Cincinnati, OH 45267, USA. hussaist@ucmail.uc.edu
Sayed T
ST
Hussain
Seher
S
Iqbal
Syed N
SN
Ahmed
Saeb F
SF
Khoury
Faisal M
FM
Syed
D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001282:Atrial Flutter / Q000209:etiology; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003971:Diastole; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D013318:Stroke Volume