Resident Report 1/6 -Intracardiac Pressures

Teaching Points:

  • Normal Intracardiac Pressures
    • Right Atrium – 0-6
    • Right Ventricle: 15-30/0-6
    • Pulmonary Artery: 15-30/6-12
    • Left Atrium: 6-12
    • Left Ventricle: 100-130/6/12
  • Heart failure exacerbations first results from elevated Left ventricular End Diastolic Pressure (LVEDP).
  • Increased LVEDP –> increased LA pressures –> increased pulmonary pressure
    • Most common cause of right heart failure is left heart failure
  • Mitral Stenosis heart sounds
    • Loud S1
      • Due to forceful closure of mitral valve.
    • Opening Snap (OS) with diastolic rumbling after S2
      • OS occurs later than along the cycle compared to a split S2 sound.
  • Most common cause of mitral stenosis is rheumatic heart disease.
  • Patients with mechanical prosthetic valves should be on Coumadin for anticoagulation due to increased thrombotic risk.
  • Newer anticoagulants including anti-X and anti-II inhibitors have been shown to increase bleeding and thrombotic risks.

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