•decreased EDV (hallmark!)
•decreased SV (hallmark!)
•acute left ventricular failure
•increased ESV (hallmark!)
What would be the pulmonary and cardiac physical findings?
•On physical examination, her vital signs are BP 100/80 mmHg, HR 115 beats/min, respirations 26/minute, and temperature 37 deg C. There are diffuse crackles throughout both lung fields. Neck veins are distended. There is a third heart sound (S3).
-nocturia (fluid re-aborbed)
•increased pulmonary artery pressure due to back up
Where would a third heart sound (S3) occur in the Wiggers diagram? What is the mechanism of the third heart sound? Does it only occur in heart failure?
•blood hits blood, can be normal
•aortic valve closing
Swan Ganz catheter
•Swan-Ganz catheterization is the passing of a thin tube (catheter) into the right side of the heart and the arteries leading to the lungs. It is done to monitor the heart's function and blood flow and pressures in and around the heart.
•La pressure > LV pressure - mitral valve opens
•increased wedge pressure causes early opem=ning of mitral valve and delay of closing mitral valve
A patient’s pulmonary capillary wedge pressure generally reflects the left ventricular end-diastolic pressure. What valvular abnormality would make the wedge pressure significantly higher than the true left ventricular end-diastolic pressure?
•mitral valve stenosis
What do you think the wedge pressure would be in our patient with left ventricular failure?
Cardiac silhouette: < 1/2 space betwen costophrenic angles
Edges of Heart
Fields - Lung
•8-10 ribs = deep breath