This is the only book on the market that specifically addresses cardiac blood flow findings, reviewing blood pressure tracings collected from the cardiac catheterization lab on all aspects of cardiovascular disease, as well as normal cardiac function. This edition includes revised and updated chapters on mitral stenosis and pulse alterations, low-gradient aortic valve stenosis, pulmonary balloon valvuloplasty, coronary hemodynamics for angioplasty and stenting after myocardial infarction, and more. It is an indispensable tool for physicians, nurses, and students measuring and interpreting cardiac waveforms in cardiac diagnosis and monitoring.
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CONTRIBUTORS xiii PREFACE xv INTRODUCTION xvii SECTION I: FUNDAMENTALS AND CLINICAL APPLICATIONS OF HEMODYNAMICS 1 PART 1: HEMODYNAMIC WAVEFORMS: NORMAL AND PATHOPHYSIOLOGIC 7 1 Pressure Wave Artifacts: Measurement Systems and Artifacts 9 Morton J. Kern and Steven Appleby 2 Pitfalls of Right-Heart Hemodynamics 17 Morton J. Kern and Steven Appleby 3 The Tricuspid Valve 23 Morton J. Kern and Steven Appleby 4 The Left-Sided V Wave 33 Morton J. Kern and Steven Appleby 5 The LVEDP 43 Morton J. Kern and Steven Appleby 6 Simultaneous Left and Right Ventricular Pressure Measurements 49 Morton J. Kern and Steven Appleby 7 Effects of Nitroglycerin 55 Morton J. Kern and Steven Appleby 8 Pulsus Alternans 63 Morton J. Kern and Steven Appleby PART 2: VALVULAR HEART DISEASE 69 9 Aortic Stenosis 71 Abhay Laddu and Michael J. Lim 10 Aortic Regurgitation 89 Robert H. Neumayr and Michael J. Lim 11 Aortic Regurgitation-Case Presentations 97 Morton J. Kern 12 Abnormal Hemodynamics After Prosthetic Aortic Root Reconstruction: Aortic Stenosis or Insufficiency? 105 Morton J. Kern, Frank V. Aguirre, and Marco Guerrero 13 Acute Aortic Insufficiency-Case Presentation 111 Krystof J. Godlewski, J. David Talley, and Glenn T. Morris 14 Multivalvular Regurgitant Lesions 117 Morton J. Kern, Frank V. Aguirre, Thomas J. Donohue, and Richard G. Bach 15 The Hemodynamic Dilemma of Combined Mitral and Aortic Stenosis 123 William M. Suh and Morton J. Kern 16 Determination of the Source and Severity of a Transvalvular Left Ventricular Outflow Tract Gradient in Patients with a Prosthetic Aortic Valve 129 Michael Ragosta, D. Scott Lim, and James Bergin 17 Mitral Valve Gradients-Section I 135 Morton J. Kern and Frank V. Aguirre 18 Mitral Valve Gradients-Section II: Mitral Stenosis and Pulsus Alternans 143 Morton J. Kern 19 Mitral Valve Gradients-Section III 149 Elie Azrak, Morton J. Kern, Richard G. Bach, and Thomas J. Donohue 20 Mitral Valve Gradients-Section IV: Left Ventricular Puncture for Hemodynamic Evaluation of Double Prosthetic Valve Stenosis 155 Morton J. Kern 21 Simplified Mitral Valve Gradient Calculation by Cui et al. 161 Morton J. Kern 22 Invasive Assessment of Mitral Regurgitation: Comparison of Hemodynamic Parameters 163 Morton J. Kern 23 The Pulmonary Valve 167 Morton J. Kern 24 Percutaneous Balloon Valvuloplasty 173 Zoltan Turi and Morton J. Kern PART 3: VALVULOPLASTY 197 25 Mitral Valve Gradients and Valvuloplasty 199 Morton J. Kern and Frank V. Aguirre 26 Reduction of Mitral Regurgitation After Aortic Valvuloplasty 205 Ted Feldman 27 Aortic Valvuloplasty in a Very Elderly Woman 211 Ted Feldman 28 Mitral Valve Gradient with Dobutamine Stress Testing 217 Ted Feldman 29 Left-Heart Catheterization and Mitral Balloon Valvuloplasty in a Patient with a Mechanical Aortic Valve 223 Douglas L. Kosmicki and Andrew D. Michaels PART 4: HEMODYNAMICS OF PERICARDIAL CONSTRAINT, MYOCARDIAL RESTRICTION, AND TAMPONADE 229 30 Constrictive Physiology 231 Stuart T. Higano, Elie Azrak, Naeem K. Tahirkheli, and Morton J. Kern 31 Post-Cardiac Surgical Constrictive Pericardial Disease 247 Elie Azrak and Morton J. Kern 32 Pericardial Compressive Hemodynamics 253 Morton J. Kern and Frank V. Aguirre 33 Unusual Hemodynamics of Constrictive Physiology 261 Morton J. Kern and Frank V. Aguirre 34 Cardiac Tamponade 269 Morton J. Kern and Frank V. Aguirre 35 Tamponade in a Patient with AIDS-Related Non-Hodgkin's Lymphoma 277 Elie Azrak, Morton J. Kern, and Richard G. Bach 36 A Novel Assessment for Constrictive Pericarditis in a Complex Patient 283 Justin A. Strote, Larry S. Dean, Steven L. Goldberg, Eric V. Krieger, and Douglas K. Stewart 37 Why Does Kussmal's Sign and Pulsus Paradoxus Occur? 289 Morton J. Kern PART 5: ARRYTHMIAS 293 38 Cardiac Arrhythmias 295 Morton J. Kern, Thomas J. Donohue, Richard G. Bach, and Frank V. Aguirre 39 Pacemaker Hemodynamics 301 Morton J. Kern and Ubeydullah Deligonul PART 6: HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY 307 40 Hypertrophic Cardiomyopathy 309 Morton J. Kern, Steven Appleby, and Ted Feldman PART 7: CORONARY HEMODYNAMICS 337 41 Coronary Hemodynamics 339 Morton J. Kern 42 Hemodynamic and Intravascular Ultrasound Assessment of an Ambiguous Left Main Coronary Artery Stenosis 367 Massoud A. Leesar and Garry S. Mintz 43 Renal Hemodynamics: Theory and Practical Tips 379 Tariq S. Siddiqui, Ziad Elghoul, Syed T. Reza, and Massoud A. Leesar PART 8: ADULT CONGENITAL ANOMALIES 387 44 Adult Congenital Anomalies 389 Morton J. Kern, Robin Abdulmalek, Frank V. Aguirre, Thomas J. Donohue, and Richard G. Bach 45 Case Studies in Congenital Cardiac Anomalies 399 Ralf J. Holzer and Ziyad M. Hijazi PART 9: EXTRA HEARTS 409 46 Extra Hearts: Unusual Hemodynamics of Heterotopic Transplant and Ventricular Assist Devices 411 Morton J. Kern, Ubeydullah Deligonul, and Leslie Miller PART 10: RIGHT VENTRICULAR DYSFUNCTION 427 47 Hemodynamic Manifestations of Ischemic Right-Heart Dysfunction 429 James A. Goldstein SECTION II: CLINICAL AND BEDSIDE APPLICATIONS OF HEMODYNAMICS 437 48 Hemodynamic Evaluation of Dyspnea 445 James A. Goldstein 49 Bedside Evaluation of Low-Output Hypotension 449 James A. Goldstein 50 Hemodynamic Evaluation of Right-Heart Failure 455 James A. Goldstein INDEX 459
