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RE: [echocardiography] Pulmonary artery pressure

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  • Yeung Wen
    In the past we have cardiology fellows asking patients for verbal consent. Now we re told to ask them ourselves.
    Message 1 of 9 , Nov 1, 2011

      In the past we have cardiology fellows asking patients for verbal consent. Now we're told to ask them ourselves.

      On Oct 21, 2011 10:21 AM, "Brenna king" <bkbroiler40@...> wrote:
       

      Ditto i so agree the feed back is so important and helpful. Who out there uses definity contrast? And if so could someone share a protocol and do you have the patient sign a consent? We just got approved and i'm interested in what others do.
      Brenda
       

      To: echocardiography@yahoogroups.com
      From: dalemyersmacon@...
      Date: Thu, 20 Oct 2011 12:02:18 -0700
      Subject: Re: [echocardiography] Pulmonary artery pressure

       
      Just a note to say how much I enjoy the feedback from everyone and especially Gershom for being so consistant in answering so many questions.  Thanks to this great community for participating.
      Dale Myers, RDCS, Forsyth, Ga.

      From: Gershom Lichtenberg <gershomsl@...>
      To: echocardiography@yahoogroups.com
      Sent: Thursday, October 20, 2011 3:09 AM
      Subject: Re: [echocardiography] Pulmonary artery pressure

       
      For practical purposes, RVSP and PA pressure are so close (if there is no Pulmonic Stenosis) that we use them interchangeably in the echo lab.

      If your doctor wants, you could take the RVSP (TR gradient + RA pressure [estimated from IVC diameter and pulsatility]) and add to it the peak gradient from your Pulmonic Valve CW tracing (generally in the 4-6 mmHg range). While this would appear to give you specifically the PA peak pressure. But remember, you are adding three numbers which are imprecise estimates, each of which is good enough for clinical estimation.

      Each estimate does not necessarily occur at the same moment in systole, so you are simply creating an imaginary improvement in actual accuracy.

      The only thing that is likely to give your physician a more accurate number is to place a catheter in the Pulmonary Artery. I don't know of anybody who finds that more practical or useful than a good estimate of peak RV systolic pressure.

      Best of luck
      Gershom Lichtenberg, RDCS
      Echocardiographer
      Rambam Healthcare Campus
      Haifa, Israel

      On Wed, Oct 19, 2011 at 7:17 PM, KATRINAC <REDKAT42025@...> wrote:
       
      This is going to be so simple for many of you: I was recently asked by a fellow sonographer:

      is rvsp and pulmonary artery pressure the same value? And if not can you tell me how to get the pulmonary artery pressure. I know where the rvsp value comes but I am confused on the other if they are not the same. Dr m wants the pulmonary art pressure instead of the rvsp but as far as I can tell from reading online is that they are the same.

      I thought was same too unless PA velocity was >2cm/s and had stenosis...how do you get a PA pressure???





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