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Books on the topic 'Elevated right ventricular pressure'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 February 2022

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1

Barnard, Matthew, and Nicola Jones. Intensive care management after cardiothoracic surgery. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0368.

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Management of the post-cardiothoracic surgical patient follows general principles of intensive care, but incorporates certain unique considerations. In cardiac surgical patients peri-operative ischaemia, arrhythmias and ventricular dysfunction mandate specific monitoring requirements, and individual pharmacological and mechanical support. Suspicion of myocardial ischaemia should not only lead to pharmacological treatment, but also consideration of urgent angiography to exclude coronary graft occlusion. Ventricular dysfunction may be pre-existing or attributable to intra-operative myocardial ‘s

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2

Kreit, John W. Right Ventricular Failure. Edited by John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0014.

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Right ventricular (RV) failure is common in the ICU. Chronic RV failure is most often due to long-standing left ventricular (LV) systolic or diastolic failure or other causes of chronic pulmonary hypertension. Acute RV failure can result from massive pulmonary embolism, ARDS, RV infarction, and acute LV failure. Finally, acute-on-chronic RV failure can be precipitated by any disorder that leads to an abrupt rise in pulmonary vascular resistance (PVR) and RV afterload. Right Ventricular Failure provides an in-depth review of the adverse hemodynamic effects of mechanical ventilation and PEEP in

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3

Rigo, Fausto, Covadonga Fernández-Golfín, and Bruno Pinamonti. Dilated cardiomyopathy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0043.

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Dilated cardiomyopathy (DCM) is characterized by a globally dilated and dysfunctioning left ventricle (LV). Therefore, echocardiographic diagnostic criteria for DCM are a LV end-diastolic diameter greater than 117% predicted value corrected for age and body surface area and a LV ejection fraction less than 45% (and/or fractional shortening less than 25%). Usually, the LV is also characterized by a normal or mildly increased wall thickness with eccentric hypertrophy and increased mass, a spherical geometry (the so-called LV remodelling), a dyssynchronous contraction (typically with left bundle

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4

van den Bosch, Annemien E., Luigi P. Badano, and Julia Grapsa. Right ventricle and pulmonary arterial pressure. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0023.

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Right ventricular (RV) performance plays an important role in the morbidity and mortality of patients with left ventricular dysfunction, congenital heart disease, and pulmonary hypertension. Assessment of RV size, function, and haemodynamics has been challenging because of its complex geometry. Conventional two-dimensional echocardiography is the modality of choice for assessment of RV function in clinical practice. Recent developments in echocardiography have provided several new techniques for assessment of RV dimensions and function, include tissue Doppler imaging, speckle-tracking imaging,

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5

Elliott, Perry, Kristina H. Haugaa, Pio Caso, and Maja Cikes. Restrictive cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0044.

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Restrictive cardiomyopathy is a heart muscle disorder characterized by increased myocardial stiffness that results in an abnormally steep rise in intraventricular pressure with small increases in volume in the presence of normal or decreased diastolic left ventricular volumes and normal ventricular wall thickness. The disease may be caused by mutations in a number of genes or myocardial infiltration. Arrhythmogenic right ventricular cardiomyopathy is an inherited cardiac muscle disease associated with sudden cardiac death, ventricular arrhythmias, and cardiac failure. It is most frequently cau

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6

Voilliot, Damien, Jaroslaw D. Kasprzak, and Eduardo Bossone. Diseases with a main influence on right ventricular function. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0060.

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As an important and independent predictive factor of morbidity and mortality, right ventricular (RV) function should be carefully assessed in patients with chronic obstructive lung disease, lung fibrosis, liver cirrhosis, or obesity. RV assessment requires a complete study of the ‘RV-pulmonary circulation unit’ with estimation of RV preload, RV intrinsic contractility, and RV afterload. Therefore, estimation of pulmonary arterial pressure, pulmonary vascular resistance, and left ventricular systolic and diastolic function should be included in this evaluation, in addition to conventional RV sy

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7

Hedenstierna, Göran, and Hans Ulrich Rothen. Physiology of positive-pressure ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0088.

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During positive pressure ventilation the lung volume is reduced because of loss of respiratory muscle tone. This promotes airway closure that occurs in dependent lung regions. Gas absorption behind the closed airway results sooner or later in atelectasis depending on the inspired oxygen concentration. The elevated airway and alveolar pressures squeeze blood flow down the lung so that a ventilation/perfusion mismatch ensues with more ventilation going to the upper lung regions and more perfusion going to the lower, dependent lung. Positive pressure ventilation may impede the return of venous bl

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8

Joanna Burton, Vera, and Edward Ahn. Congenital Hydrocephalus. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0076.

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Congenital hydrocephalus is defined as the abnormal accumulation of cerebrospinal fluid resulting in the enlargement of the ventricular system in which the intracranial pressure is known or suspected to be elevated and present since before birth. Congenital hydrocephalus can occur in isolation but is often associated with other conditions such as aqueductal stenosis and spina bifida. Surgery, generally the placement of a ventriculopritoneal shunt, is the mainstay of treatment. Cognitive outcomes are variable and most predicted by associated disability.

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9

O’Neal, M. Angela. Postpartum Left-Sided Numbness and Right-Sided Shaking. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0019.

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The chapter discusses cerebral venous thrombosis (CVT) in pregnancy. The signs and symptoms of the patient depend on which venous sinus is clotted. The clinical features may include headache, bilateral symptoms, hemorrhagic stroke, and seizures. The headaches are related to elevated intracranial pressure and can mimic those of idiopathic intracranial hypertension. Hematological changes that occur in pregnancy result in a hypercoagulable state; this normal physiology can predispose in certain situations to CVT. Other factors associated with an increase in the risk of clotting include infection,

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10

Smiseth, Otto A., Maurizio Galderisi, and Jae K. Oh. Left ventricle: diastolic function. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0021.

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Evaluation of diastolic function by echocardiography is useful to diagnose heart failure with preserved ejection fraction by showing signs of diastolic dysfunction, and regardless of ejection fraction, echocardiography can be used to estimate left ventricular (LV) filling pressure. Diastolic dysfunction occurs in a number of cardiac diseases other than heart failure and mild diastolic dysfunction is part of the normal ageing process. The fundamental disturbances in diastolic dysfunction are slowing of myocardial relaxation, loss of restoring forces, and reduced LV chamber compliance. As a comp

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11

Maizel, Julien, and Michel Slama. Doppler echocardiography in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0141.

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The capacity of echocardiography to non-invasively identify the major causes of circulatory failure has made it increasingly popular in the intensive care unit (ICU) setting. Assessing cardiac performance in shocked patients is a key point in therapeutic support decision-making. Analysing left and right ventricular function and morphology should be mandatory in the training curriculum of ICU physicians. Haemodynamic evaluation relies on several parameters examining left ventricular systolic and diastolic function, left ventricular filling pressure, fluid responsiveness, and right ventricular f

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12

Lee, Jae Myeong, and Michael R. Pinsky. Cardiovascular interactions in respiratory failure. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0087.

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Acute respiratory failure not only impairs gas exchange, but also stresses cardiovascular reserve by increasing the need for increased cardiac output (CO) to sustain O2 delivery in the face of hypoxaemia, increased O2 demand by the increased work of breathing and inefficient gas exchange, and increased right ventricular afterload due to lung collapse via hypoxic pulmonary vasoconstriction. Mechanical ventilation, though often reversing these processes by lung recruitment and improved arterial oxygenation, may also decrease CO by increasing right atrial pressure by either increasing intrathorac

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13

Orenbuch-Harroch, Efrat, and Charles L. Sprung. Pulmonary artery catheterization in the ICU. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0133.

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Haemodynamic monitoring is a significant component in the management of critically-ill patients. Flow-directed pulmonary artery catheters (PAC) are a simple and rapid technique for measuring several continuous or intermittent circulatory variables. The PAC is helpful in diagnosis, guidance of therapy, and monitoring therapeutic interventions in various clinical conditions, including myocardial infarction and its complications, non-cardiogenic pulmonary oedema and severely ill patients.The catheter is inserted through a large vein. The PAC is advanced, after ballooninflation with 1.5 mL of air,

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14

Kreit, John W. Cardiovascular–Pulmonary Interactions. Edited by John W. Kreit. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190670085.003.0003.

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Intramural pressures within a tube or circuit determine the rate and direction of flow, whereas the transmural pressure of an elastic structure determines its volume. In Chapter 1, we applied these principles when talking about the pressure needed to overcome viscous forces and elastic recoil during ventilation. In this chapter, we use them to explain changes in blood flow between two portions of the circulatory system and changes in the volume and size of the heart chambers. Cardio–Pulmonary Interactions provides an overview of essential cardiovascular physiology as well as an in-depth discus

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15

Price, Laura, and S. John Wort. Pathophysiology and causes of pulmonary hypertension. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0168.

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Pulmonary hypertension (PH) in the setting of critical illness may reflect the acute syndrome itself (such as acute massive pulmonary embolism or acute lung injury), and/or pre-existing ‘chronic’ causes of PH. To compound this, iatrogenic factors may also contribute to PH including the effects of positive pressure ventilation and certain vasoactive drugs. The presence of PH, especially when complicated by resulting right ventricular (RV) dysfunction and failure, is a poor prognostic feature in all settings. This chapter reviews the pathophysiology of acute PH in critical illness, and pre-exist

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16

Anwar, Ashraf M., and Folkert Jan ten Cate. Tricuspid and pulmonary valves. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0016.

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Right-sided heart valves are complex anatomical structures. Studies describing the morphological and functional assessment of both valves are lacking. Most echocardiographic modalities provide a qualitative rather than quantitative approach.Echocardiography has a central role in the assessment of tricuspid regurgitation through estimation of severity, understanding the mechanism, assessment of pulmonary artery pressure, evaluation of right ventricular function, guidance towards surgery versus medical therapy, and assessment of valve competence after surgery.Transoesophageal echocardiography is

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17

Whitworth, Caroline, and Stewart Fleming. Malignant hypertension. Edited by Neil Turner. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0216.

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Malignant hypertension (MH) is recognized clinically by elevated blood pressure together with retinal haemorrhages or exudates with or without papilloedema (grades III or IV hypertensive retinopathy); and may constitute a hypertensive emergency or crisis when complicated by evidence of end-organ damage including microangiopathic haemolysis, encephalopathy, left ventricular failure, and renal failure. Though reversible, it remains a significant cause of end-stage renal failure, and of cardiovascular and cerebrovascular morbidity and mortality in developing countries.MH can complicate pre-existi

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18

Schairer, John R., and Steven J. Keteyian. Pathophysiology and causes of pericardial tamponade. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0166.

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Pericardial disease leading to pericardial effusion (PEF) is a common clinical disorder. The most common causes are viral infections, metastatic cancer, renal disease, and bleeding disorders. PEF that accumulates slowly can become quite large before haemodynamic embarrassment occurs, while PEF that accumulates rapidly from trauma or aortic dissection can be small,yet cause haemodynamic embarrassment. As the PEF increases in size, the pressure in the pericardial space increases, leading to a decrease in atrial and ventricular chamber sizes, and limiting filling of the chambers. Ultimately, card

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19

Stocchetti, Nino, and Andrew I. R. Maas. Causes and management of intracranial hypertension. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0233.

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Intracranial hypertension may damage the brain in two ways—it causes tissue distortion and herniation, and reduces cerebral perfusion. The many different pathologies that can result in intracranial hypertension include subarachnoid haemorrhage, spontaneous intra-parenchymal haemorrhage, malignant cerebral hemispheric infarction, and acute hydrocephalus. The pathophysiology and specific treatment of intracranial hypertension may be different and depend on aetiology. In patients with subarachnoid haemorrhage a specific focus is on treating secondary hydrocephalus and maintaining adequate cerebra

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