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RV pressure overload and septal bounce

added by drdavemd

RV pressure overload and septal bounce
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Posted By: EHaumann (1103 days ago)

sorry after reading the question again it doesn't make sense, so here
it goes again keeping the followin statement in mind:

in RV
pressure overload there is leftward ventricular septal shift and
reversal of septal curvature present throughout the cardiac cycle with
most marked distortion of the left ventricle at end-systole.
In a
patient with RV volume overload, the septal shift and flattening of VS
curvature occurs predominantly in mid to late diastole with relative
sparing of LV deformation at end-systole.

With this
statement in mind, does this still apply in a post-op septal state?

Posted By: EHaumann (1103 days ago)

Just a question ~ will the use of the cardiac cycle to see when the
flattening occur still be useful/accurate in the presence of the
abnormal/bouncy septal motion(Post AVR)?

Posted By: diego (1107 days ago)

YEA DRDAVEMD IT DOES SEEM THAT THE FLATTENING OCCURS IN SYSTOLIC PHASE
OF CARDIAC CYCLE , VERY TYPICALFOR RV ISOLATED OVERPRESSURE WITHOUT
CONCOMITANT RV VOLUME OVERLOAD

Posted By: diego (1108 days ago)

Hey Jorg when you say COMET TAIL ....You mean water in the
interlobular septa of the wet lung or you talk about a real artifact
???? I do think that is quite common this sign of extravascular water
in such patients....you talk about that??? Sorry for any interruption
between you and the sender of this nice clip

Posted By: Emmel (1108 days ago)

I'm very sorry, I've done an orthographic mistake: I intended to
write/ say "COMET-TAIL-ARTEFACT" not "COMMON-TAIL-ARTEFACT".
I
thank for having patience.

Posted By: Emmel (1108 days ago)

Thanks a lot for this impressive vid!
I´m under the impression,
that there is a systolic (perhaps caused by a PH; is a lung diesease
known as underlying disease like COPD?) AND a diastolic (volume
overload?) flattening of the IVS.
I´ve noticed two artefacts:
one artefact of the lung ventral to the left ventricle (seems like a
common-tail-artefact, respectively a rocket-artefact of the lung) >
any indications of lung oedema except that artefact?
the other
artefact flashes in the course of systole ventral to the left
ventricle depicted as a bright stripe: It seems like an artefact of
the lung, too, I couldn´t clearly distinguish, whether it is an
artefact of the lung or of the pericardium. But I don´t think it is
an artefact of the pericardium, because that would mean AIR in the
pericardial sac.

Thanks you very much for sharing that vid!


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drdavemd

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Added: 07-12-2011
Runtime: 0m 2s
Views: 11638
Comments: 6

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Description

In this parasternal short axis transthoracic clip, you can see the D shape of the LV common in patients with RV pressure overload. The IV septum also bounces in this particular patient with a history of sternotomy for aortic valve replacement.


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