Question

Measurement	Value	Normal Values
right atrium (mean)	6 mmHg	2 – 6 mm Hg
right ventricle (systolic/diastolic/end diastolic)	30/2/8 mmHg	15 – 30 mmHg systolic 2 – 8 mmHg diastolic 5 -12 mmHg end diastolic
pulmonary artery (systolic/diastolic/mean)	30/6/14 mmHg	15 – 30 mmHg systolic 4 – 12 mmHg diastolic 9 – 19 mmHg mean
left atrium (mean)	6 mm Hg	2 – 12 mmHg
left ventricle (systolic/diastolic/end diastolic)	106/-3/10 mmHg	90 – 140 mmHg systolic 5 – 12 mmHg diastolic 5 – 12 mmHg end diastolic
aorta (systolic/diastolic/mean)	102/66/84 mmHg	90 – 140 mmHg systolic 60 – 90 mmHg diastolic 70 – 105 mean

Highlight the abnormal pressure findings in the chart above.

6. From the data in the pressure chart above, where is the location of the abnormal blood flow path in
this patient?

7. The defect in Jolene’s heart allows blood to mix between the two chambers (you need to determine
which chambers are involved in this case). Due to this defect, what would happen to the right side
of Jolene’s heart over time?

8. What would happen to the stroke volume in the right side of the heart?
  

9. What would happen to the stroke volume in left side of Jolene’s heart over time?

10. What abnormality in the heart sounds (S1 and/or S2) would alert the cardiologist in Jolene’s case?

Answer 1

Answer 6

According to chart

Right atrial pressure is normal which is 2-6 mmhg.

Right ventricular pressure systolic is slightly elevated (normal 15- 25 mmHg). Right ventricular diastolic is normal ( normal 0-8 mm Hg).Right ventricular end diastolic pressure is slightly elevated ( normal 3-7 mmHg)

Pulmonary artery systolic pressure is elevated ( normal is 15-25 mm Hg). Diastolic is reduced (normal is 8-15 mmHg).Mean pulmonary artery pressure is normal ( normal 10- 20 mmHg)

Left atrial pressure is on the lower border ( normal 6 - 12 mm Hg).

Left ventricular systolic is normal (normal 100-140 mm Hg). Diastolic pressure is low ( normal is 3 -12 mmHg).

Aortic pressure systolic is normal. Diastolic is also normal.

As there is significant changes in the presures of pulmonary artery pressures as well as right ventricular end diastolic presssure there may be a chance of tricuspid incompetency and or pulmonary artery valve anomalies.

Answer 7

Since there is back flow of the blood from right atrium to right ventricle, pulmonary artery to right ventricle during diastole there will be an increased end diastolic pressure dialation of right ventricle over time

Answer 8

Stroke volume is increased since regurgitation occurs.

Amswer 9

Stroke volume will be eventually reduced.

Answer 10

There is chances of holo systolic murmurs which can happen with each contraction.