Quantification of pressure gradients
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- One of the ways to understand pressure gradients within the heart is by using Doppler echocardiography
- Continuous wave doppler measures the velocity of the flow of blood within the heart
- A modified Bernoulli Equation is applied in order to determine the pressure difference across a valve or between two cardiac chambers based on the measured peak velocity of blood flow
Bernoulli Equation: Pressure change = 4 x velocity^2
- This technique is used to calculate pressure gradients across stenotic valves and also to estimate pulmonary artery systolic pressures (PASP) non-invasively
- Of note, it measures the difference between chambers, not the absolute pressure
- Example: calculating the PASP
- in patients with tricupsid regurgitation can use Bernoulli equation to calculate the systolic pressure change between the RA and RV
- adding the assumed RA systolic pressure give the RV systolic pressure
- the RV systolic pressure equals the PA systolic pressure if there is no RVOT obstruction
References
- Kasper et al. Harrison's Principles of Internal Medicine, 16th Edition. Chapter 211: Noninvasive cardiac imaging.
- Ahmed et al. Echocardiographic evaluation of hemodynamic parameters. Critical Care Medicine 2007; 35(8).
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