1. Mrs G has had long-standing MS without MR and moderate aortic regurgitation with trivial aortic..

1. Mrs G has had long-standing MS without MR and moderate aortic regurgitation with trivial aortic stenosis. She has had a progressive increase in dyspnea and palpitations and is brought to the cardiac catheterization lab for hemodynamic confirmation of her diagnosis. In the cardiac catheterization laboratory she is noted to have a heart rate of 62, a right atrial mean pressure of 5 mm Hg, a PA pressure of 55/25 with a mean of 35 mm Hg and a PCW pressure of 26 mm Hg. Her left ventricular end diastolic pressure (LVEDP) is 15 mm Hg. A mean mitral gradient of 9 mm Hg and an aortic mean gradient

View complete question »1. Mrs G has had long-standing MS without MR and moderate aortic regurgitation with trivial aortic stenosis. She has had a progressive increase in dyspnea and palpitations and is brought to the cardiac catheterization lab for hemodynamic confirmation of her diagnosis. In the cardiac catheterization laboratory she is noted to have a heart rate of 62, a right atrial mean pressure of 5 mm Hg, a PA pressure of 55/25 with a mean of 35 mm Hg and a PCW pressure of 26 mm Hg. Her left ventricular end diastolic pressure (LVEDP) is 15 mm Hg. A mean mitral gradient of 9 mm Hg and an aortic mean gradient of 10 mm Hg are noted. Her cardiac output is 3 L per minute using Fick oximetry data from PA and femoral artery samples and an assumed oxygen consumption value. A left ventricular angiogram reveals no MR and normal LV systolic function. An aortic root angiogram reveals 2+aortic regurgitation. The cardiology fellow in the laboratory determines that the MVA is 1.0 cm2. Which of the following is a correct statement regarding the hemodynamics? (A) She has both severe aortic stenosis and MS (B) The MVA of 1.0 cm2 is probably correct as determined (C) The MVA is incorrect based on the data and should be approximately 2.1 cm2 instead of 1.0 cm2 (D) The associated aortic regurgitation makes it impossible to calculate an MVA by any means and an MVA should not be reported (E) None of the above statements is correct

View less »