|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1987; 10:1201-1206 © 1987 by the American College of Cardiology Foundation |
Respiratory Intensive Care Unit, Ambroise Pare Hospital, Boulogne, France.
In 14 patients requiring aggressive therapy for circulatory failure resulting from massive pulmonary embolism, hemodynamic and two-dimensional echocardiographic data were obtained at bedside (acute phase) and again after circulatory improvement (intermediate phase) and during recovery. The acute stage was characterized by a low cardiac output state despite inotropic support (cardiac index 1.9 +/- 0.6 liters/min per m2) associated with increased right atrial pressure (12.4 +/- 4.2 mm Hg), increased right ventricular end-systolic and end-diastolic area (12.4 +/- 3.4 and 15.4 +/- 4.1 cm2/m2, respectively) and reduced right ventricular fractional area contraction (20.1 +/- 8.6%). Two-dimensional echocardiography also revealed interventricular septal flattening at both end-systole and end-diastole and markedly decreased left ventricular end-diastolic dimensions. Left ventricular fractional area contraction remained normal. Hemodynamic improvement occurred during the intermediate phase as shown by restoration of cardiac index (3.3 +/- 0.6 liters/min per m2), decrease in right atrial pressure (8.3 +/- 4.8 mm Hg), reduction in right ventricular end-systolic area (9.0 +/- 3.6 cm2/m2 at the intermediate stage and 6.1 +/- 1.8 cm2/m2 at recovery) and end-diastolic area (10.5 +/- 3.6 cm2/m2 at the intermediate stage and 8.9 +/- 2.9 cm2/m2 at recovery) and improvement in right ventricular fractional area contraction (31.5 +/- 16.4%). The interventricular septum progressively returned to a more normal configuration at both end-systole and end-diastole, and left ventricular diastolic dimension steadily increased. It is concluded that circulatory failure secondary to massive pulmonary embolism was mediated through a profound decrease in left ventricular preload, resulting from both pulmonary outflow obstruction and reduced left ventricular diastolic compliance.(ABSTRACT TRUNCATED AT 250 WORDS)
This article has been cited by other articles:
|
|
 |
|
  R. Potkin, V. Cheng, and R. Siegel Effects of glossopharyngeal insufflation on cardiac function: an echocardiographic study in elite breath-hold divers J Appl Physiol, September 1, 2007; 103(3): 823 - 827. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. S. Darze, A. L. Latado, A. G. Guimaraes, R. A. V. Guedes, A. B. Santos, S. S. de Moura, and L. C. S. Passos Acute Pulmonary Embolism Is an Independent Predictor of Adverse Events in Severe Decompensated Heart Failure Patients Chest, June 1, 2007; 131(6): 1838 - 1843. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Tji-Joong Gan, J.-W. Lankhaar, J. T. Marcus, N. Westerhof, K. M. Marques, J. G. F. Bronzwaer, A. Boonstra, P. E. Postmus, and A. Vonk-Noordegraaf Impaired left ventricular filling due to right-to-left ventricular interaction in patients with pulmonary arterial hypertension Am J Physiol Heart Circ Physiol, April 1, 2006; 290(4): H1528 - H1533. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Shanewise How to Reliably Detect Ischemia in the Intensive Care Unit and Operating Room Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2006; 10(1): 101 - 109. [Abstract] [PDF]
|
|
|
|
|
|
G. Piazza and S. Z. Goldhaber The Acutely Decompensated Right Ventricle: Pathways for Diagnosis and Management Chest, September 1, 2005; 128(3): 1836 - 1852. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Beaulieu and P. E. Marik Bedside Ultrasonography in the ICU: Part 1 Chest, August 1, 2005; 128(2): 881 - 895. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Anderson, S. K Shernan, M. Leacche, J. D. Rawn, S. Paul, T. Mihaljevic, J. A. Jarcho, L. W. Stevenson, J. C.-T. Fang, E. F. Lewis, et al. Severity of Intraoperative Tricuspid Regurgitation Predicts Poor Late Survival Following Cardiac Transplantation Ann. Thorac. Surg., November 1, 2004; 78(5): 1635 - 1642. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. Kreit The Impact of Right Ventricular Dysfunction on the Prognosis and Therapy of Normotensive Patients With Pulmonary Embolism Chest, April 1, 2004; 125(4): 1539 - 1545. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Fox, V. Formanek, A. Friedrich, and S. K. Shernan Intraoperative Echocardiography Card. Surg. Adult, January 1, 2003; 2(2003): 283 - 314. [Full Text]
|
|
|
|
 |
|
 A. Vieillard-Baron, S. Prin, K. Chergui, O. Dubourg, and F. Jardin Echo-Doppler Demonstration of Acute Cor Pulmonale at the Bedside in the Medical Intensive Care Unit Am. J. Respir. Crit. Care Med., November 15, 2002; 166(10): 1310 - 1319. [Full Text] [PDF]
|
|
|
|
|
|
K. E. Wood Major Pulmonary Embolism : Review of a Pathophysiologic Approach to the Golden Hour of Hemodynamically Significant Pulmonary Embolism Chest, March 1, 2002; 121(3): 877 - 905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Shirakabe, S. Yamaguchi, Y. Tamada, G. Baniya, A. Fukui, H. Miyawaki, and H. Tomoike Impaired distensibility of the left ventricle after stiffening of the right ventricle J Appl Physiol, July 1, 2001; 91(1): 435 - 440. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Grifoni, I. Olivotto, P. Cecchini, F. Pieralli, A. Camaiti, G. Santoro, A. Conti, G. Agnelli, and G. Berni Short-Term Clinical Outcome of Patients With Acute Pulmonary Embolism, Normal Blood Pressure, and Echocardiographic Right Ventricular Dysfunction Circulation, June 20, 2000; 101(24): 2817 - 2822. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Arcasoy and J. W. Kreit Thrombolytic Therapy of Pulmonary Embolism: A Comprehensive Review of Current Evidence Chest, June 1, 1999; 115(6): 1695 - 1707. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Chartier, J. Bera, M. Delomez, P. Asseman, J.-P. Beregi, J.-J. Bauchart, H. Warembourg, and C. Thery Free-Floating Thrombi in the Right Heart : Diagnosis, Management, and Prognostic Indexes in 38 Consecutive Patients Circulation, June 1, 1999; 99(21): 2779 - 2783. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T B Oliver, J H Reid, and J T Murchison Interventricular septal shift due to massive pulmonary embolism shown by CT pulmonary angiography: an old sign revisited Thorax, December 1, 1998; 53(12): 1092 - 1094. [Abstract] [Full Text]
|
|
|
|
|
|
J. J. Atherton, H. L. Thomson, T. D. Moore, K. N. Wright, G. W. F. Muehle, L. E. Fitzpatrick, and M. P. Frenneaux Diastolic Ventricular Interaction : A Possible Mechanism for Abnormal Vascular Responses During Volume Unloading in Heart Failure Circulation, December 16, 1997; 96(12): 4273 - 4279. [Abstract] [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
