tailieunhanh - Clinical hemodynamics - Textbook (Second edition): Part 2

(BQ) Continued part 1, part 2 of the document Clinical hemodynamics - Textbook (Second edition) has contents: Right-sided heart disorders, pulmonary hypertension and related disorders, pericardial disease and restrictive myocardial diseases, left-ventricular hemodynamics, heart failure, and shock, congenital heart disease, and other contents. Invite you to refer. | RIGHT-SIDED HEART DISORDERS Michael Ragosta CHAPTER 7 After Werner Forssmann boldly inserted a urological catheter into his own right atrium the right heart became accessible to clinical investigation allowing the study of right-heart physiology in both normal and diseased The right heart is affected by many cardiac disease states. Recall that the prii left- cause of right-heart failure is left-heart failure therefore the myriad cardiac disorders associated with heart failure syndromes often impact right-heart hemodynamics. In addition numerous congenital heart conditions as well as disorders of the pericardium affect right-heart hemodynamics. The influences these conditions have on right-heart hemodynamics are discussed in their respective chapters. This chapter will focus on disorders unique to the right heart including tricuspid and pulmonic valvular diseases and the hemodynamics of right-ventricular failure with a focus on right-ventricular infarction. TRICUSPID VALVE STENOSIS This rare valvular lesion is most often due to rheumatic heart disease and is almost always associated with mitral stenosis isolated rheumatic tricuspid stenosis is very Only occasionally is tricuspid stenosis caused by other conditions including carcinoid syndrome endomyocardial fibrosis congenital tricuspid valve stenosis endocarditis pacemaker lead-related leaflet fibrosis or atrial myxoma. In the current era perhaps the most commonly observed cause of tricuspid stenosis is dysfunction of a prosthetic tricuspid valve. Tricuspid stenosis impairs right-atrial emptying and elevates right-atrial pressure. Diminished filling of the right ventricle reduces cardiac output. In cases of rheumatic heart disease the combination of tricuspid and mitral stenosis reduces the cardiac output to levels lower than expected on the basis of either valvular lesion alone. Clinical consequences of severe tricuspid stenosis include fatigue caused by low cardiac output elevated jugular veins .