Interpretation of cardiac pathophysiology from pressure waveform analysis: Pericardial compressive hemodynamics, part 1

Kern, Morton J.; Aguirre, Frank V.

doi:10.1002/ccd.1810250418

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Ultimately, one can make the diagnosis with the aid of modern techniques of heart imaging studies (echocardiography, computed tomography, and magnetic resonance imaging) and invasive cardiac catheterization. 2,12,13 The bedside finding of an elevated jugular venous pressure with a low BNP may be helpful in identifying patients with constrictive pericarditis, 14 but may also be due to tricuspid stenosis or superior vena cava obstruction.…”

Section: Discussionmentioning

confidence: 99%

Computerized Acoustic Cardiographic Insights into the Pericardial Knock in Constrictive Pericarditis

Michaels

Viswanathan

Jordan

et al. 2007

Clinical Cardiology

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SummaryBackground: One of the clinical hallmarks of constrictive pericarditis is the pericardial knock, a high-pitched early diastolic heart sound. Making the clinical diagnosis of constrictive pericarditis is challenging, as is accurate auscultation of the pericardial knock.Hypothesis: We sought to assess the utility of a computerized acoustic cardiographic device in the assessment of the pericardial knock in patients with constrictive pericarditis.Methods: We report a case series in which computerized acoustic cardiography (Audicor, Inovise Medical Inc., Portland, OR) is performed in patients with constrictive pericarditis.Results: Three patients with constrictive pericarditis underwent computerized acoustic cardiographic recordings at the time of cardiac catheterization. In each case, initial physical examination by the internist and referring cardiologist did not appreciate a pericardial knock. Acoustic cardiography demonstrated a high-pitched early diastolic sound in each case. Time-frequency representation analyses showed the high-frequency components of the pericardial knock sound. Repeat acoustic cardiography demonstrated resolution of the pericardial knock after pericardiectomy in two patients.Conclusions: Non-invasive computerized acoustic cardiography can demonstrate the high-pitched pericardial

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Section: Discussionmentioning

confidence: 99%

Computerized Acoustic Cardiographic Insights into the Pericardial Knock in Constrictive Pericarditis

Michaels

Viswanathan

Jordan

et al. 2007

Clinical Cardiology

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“…Compression of the heart due to pericardial fluid results in an increased CVP, as well as in a reduced cardiac diastolic volume, stroke volume, and cardiac output. Despite the hemodynamic similarities between pericardial constriction and tamponade, the PAP waveform is slightly different [ 65 ]. The characteristic of the CVP waveform in cardiac tamponade is monophasic and dominated by a systolic x-descent.…”

Section: Placement Of the Pulmonary Artery Cathetermentioning

confidence: 99%

“…This is caused by the difference in blood flow from the vena cava to the right atrium between pericardial constriction and tamponade. In cardiac tamponade, venous return to the right atrium is limited to the period of atrial relaxation (x-descent), whereas in restrictive pathophysiology, it is biphasic with a peak during atrial relaxation and early ventricular filling (x- and y-descent) [ 65 ].…”

Section: Placement Of the Pulmonary Artery Cathetermentioning

confidence: 99%

The contemporary pulmonary artery catheter. Part 1: placement and waveform analysis

Bootsma

Boerma

Lange

et al. 2021

J Clin Monit Comput

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Nowadays, the classical pulmonary artery catheter (PAC) has an almost 50-year-old history of its clinical use for hemodynamic monitoring. In recent years, the PAC evolved from a device that enabled intermittent cardiac output measurements in combination with static pressures to a monitoring tool that provides continuous data on cardiac output, oxygen supply and-demand balance, as well as right ventricular (RV) performance. In this review, which consists of two parts, we will introduce the difference between intermittent pulmonary artery thermodilution using cold bolus injections, and the contemporary PAC enabling continuous measurements by using a thermal filament which at random heats up the blood. In this first part, the insertion techniques, interpretation of waveforms of the PAC, the interaction of waveforms with the respiratory cycle and airway pressure as well as pitfalls in waveform analysis are discussed. The second part will cover the measurements of the contemporary PAC including measurement of continuous cardiac output, RV ejection fraction, end-diastolic volume index, and mixed venous oxygen saturation. Limitations of all of these measurements will be highlighted there as well. We conclude that thorough understanding of measurements obtained from the PAC are the first step in successful application of the PAC in daily clinical practice.

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Cardiac Tamponade

And¹,

Stouffer²

2007

Cardiovascular Hemodynamics for the Clinician

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Interpretation of cardiac pathophysiology from pressure waveform analysis: Pericardial compressive hemodynamics, part 1

Cited by 10 publications

References 11 publications

Computerized Acoustic Cardiographic Insights into the Pericardial Knock in Constrictive Pericarditis

Computerized Acoustic Cardiographic Insights into the Pericardial Knock in Constrictive Pericarditis

The contemporary pulmonary artery catheter. Part 1: placement and waveform analysis

Cardiac Tamponade

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