Revista portuguesa de cardiologia : orgão oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology
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Mitral stenosis is the most common valvular heart lesion found in pregnancy. When severe, it leads to significant maternal and fetal morbidity and mortality, since the hemodynamic adaptations to pregnancy are badly tolerated. Pregnancy can lead to development of heart failure in patients with asymptomatic or even unknown mitral stenosis, as a result of the increased mitral valve pressure gradient caused by the physiologic increase in heart rate and blood volume in pregnancy. When symptoms persist despite optimal medical therapy, the poor prognosis justifies the correction of mitral stenosis during pregnancy. ⋯ In pregnant patients who have severe mitral stenosis and persistent congestive heart failure symptoms despite conventional medical treatment, when feasible, percutaneous balloon mitral valvuloplasty is the best treatment.
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Hemodynamic changes occur during weaning from mechanical ventilation, especially after disconnection from positive pressure ventilation. Their importance has been insufficiently studied, although some refer to their role in weaning. The authors studied the hemodynamic implications after ventilator disconnection, using echocardiography. They found isovolumetric relaxation time to be a good predictor of successful weaning, proving the importance of the diastole changes with the hemodynamic adaptation in the transition to negative pressure ventilation.
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Comparative Study
Evaluation of aortic stenosis severity: role of contrast echocardiography in comparison with conventional echocardiography and cardiac catheterization.
To evaluate the role of contrast Doppler echocardiography in the assessment of aortic stenosis severity, in comparison with the conventional method and using the catheterization study as the gold standard. ⋯ In this study, contrast Doppler yielded high correlations with invasive data and higher sensitivity and specificity for detection of severe aortic stenosis than conventional Doppler. It is a useful method for evaluation of aortic stenosis severity.
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Central venous pressure (CVP) is an important hemodynamic parameter, reflecting the patient's volume status. Although some studies of non-invasive evaluation of CVP by echocardiography exist, an exact quantitative method has not been described. ⋯ This new method seems reliable to evaluate non-invasively a hemodynamic parameter that until now has only been measured approximately by this approach.