Problematic persistent exercise intolerance after surgery as above.
Right heart cath: At rest: HR 94, BP 151/80, RA 0, PA 23/16 mean 14, PAW 5, CI 3.3. At maximum supine exercise (straight leg raising): HR 129, BP 186/82, RA 4, PA 41/10 mean 23, PAW 19 (?), CI 4.6. CI by thermodilution.
Normal, no evidence of cardiomyopathy, normal filling pressures as you see. MRI is within normal range.
What was the size of the ring used for repair and size of the left atrium? We have noticed functional subvalvular mitral stenosis in a few patients with rheumatic mitral repair. We suspect that the size of the ring is relatively small when compared to dilated left atrium. The patients become symptomatic after they start to move around. This was observed in Rheumatic patients with huge left atrium. The amount of blood in the left atrium is large and our valve orifice becomes relatively small for that blood to flow through. How is the patient doing now? Did you go for any intervention?
All very complex and in fact the RHC data are inaccurate, although transcribed correctly. the low CI is at the onset of exercise not the peak. Pt had mitral valve prolapse with ruptured chords, no MS on echo, normal size LA. Pt is progressing a little, but slowly. To be honest I think there is too little data to make much of in this now. But your comment is very useful and may just be relevant.
- Badges
- Science topic
- Similar topics
- Biological Science
- Histology