{"id":52913,"date":"2022-01-25T12:19:48","date_gmt":"2022-01-25T06:49:48","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=52913"},"modified":"2022-01-24T12:28:34","modified_gmt":"2022-01-24T06:58:34","slug":"hemodynamic-quiz-2","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/hemodynamic-quiz-2\/","title":{"rendered":"Hemodynamic quiz 2"},"content":{"rendered":"

Hemodynamic quiz 2<\/span><\/h2>\n

Here are the simultaneous pressure tracings from the left ventricle and left atrium. What is the interpretation?<\/p>\n

\"Hemodynamic
Hemodynamic quiz 2<\/figcaption><\/figure>\n

In diastole, the left atrial tracing can be seen at a higher level than the left ventricular tracing, indicating a transmitral gradient. Normally, there is hardly any gradient when the mitral valve is open. So, in this case there is mitral stenosis, elevating the left atrial pressure.<\/p>\n

\"Gradient
Gradient in mitral stenosis<\/figcaption><\/figure>\n

Mean gradient across the mitral valve can be calculated using the electronic caliper and will give an assessment of the severity of mitral stenosis. Higher the gradient, more the severity of mitral stenosis.<\/p>\n

\"Mean
Mean gradient in mitral stenosis<\/figcaption><\/figure>\n

Earlier it used to be calculated using a manual planimeter on a print out the tracings on graph paper. The tracings were enlarged by changing the scale of recording so that errors could be reduced.<\/p>\n

\"Gradient
Gradient in mitral stenosis – enlarged.jpg<\/figcaption><\/figure>\n

Most often, instead of left atrial tracing, pulmonary artery wedge tracings were used as a surrogate of left atrial pressure. But a delay in transmission with phase shift could overestimate the transmitral gradient in that case.<\/p>\n

Here is the reference on phase shift causing higher gradient when pulmonary artery wedge tracing is used:<\/p>\n

1.Nishimura RA, Carabello BA. Hemodynamics in the cardiac catheterization laboratory of the 21st century<\/a>. Circulation. 2012 May 1;125(17):2138-50.<\/p>\n","protected":false},"excerpt":{"rendered":"

Hemodynamic quiz 2 Here are the simultaneous pressure tracings from the left ventricle and left atrium. What is the interpretation? In diastole, the left atrial tracing can be seen at a higher level than the left ventricular tracing, indicating a transmitral gradient. Normally, there is hardly any gradient when the mitral valve is open. So, […]<\/p>\n","protected":false},"author":1,"featured_media":52914,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-52913","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-general"],"yoast_head":"\nHemodynamic quiz 2 - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/hemodynamic-quiz-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hemodynamic quiz 2 - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Hemodynamic quiz 2 Here are the simultaneous pressure tracings from the left ventricle and left atrium. What is the interpretation? In diastole, the left atrial tracing can be seen at a higher level than the left ventricular tracing, indicating a transmitral gradient. Normally, there is hardly any gradient when the mitral valve is open. So, […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/hemodynamic-quiz-2\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2022-01-25T06:49:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2022\/01\/Hemodynamic-quiz-2.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1242\" \/>\n\t<meta property=\"og:image:height\" content=\"765\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Hemodynamic quiz 2\",\"datePublished\":\"2022-01-25T06:49:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/\"},\"wordCount\":252,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2022\\\/01\\\/Hemodynamic-quiz-2.jpg\",\"articleSection\":[\"General Cardiology\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/hemodynamic-quiz-2\\\/\",\"name\":\"Hemodynamic quiz 2 - 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