Hemodynamics: Constrictive pericarditis cases, mechanisms, technical tips- Elias Hanna, Univ of Iowa

-Case studies with a focus on the 2 pathophysiologic processes of constrictive pericarditis:
(i) ventricular interdependence with respiratory effect, and (ii) dissociation of intracardiac and intrathoracic pressures with respiration
-Focus on the 2 most important recordings illustrating them:
(i) simultaneous RV-LV recoding (mainly systolic analysis), and (ii) simultaneous LV-PCWP recording.
-Value of other cath hemodynamic findings and echo findings
-NOTE: consider watching this other video of constrictive cases, with additional pathophysiology discussions: • Hemodynamics 4: Const...

[@nicoletta.o]

Thank you for your time and amazing lecture! It is life saving :)

[@user-cu3lf3qc3u]

Amazing lectures and a great book on hemodynamics. There can be a difference between PCWP and LV if there is some constriction at AV groove or Mitral stenosis. With a LV-PCWP trace alone can we diagnose CCP? Another point - IVC pressure is not affected by respiration while SVC is affected because IVC is mainly abdominal and not thoracic ?

[@vachemanukyan7886]

You are great ! Thanks a lot!

[@areenal-taie6836]

That's a superior hemodynamic lecture at every aspect in my opinion
Thank you very much Dr Hanna
Please continue teaching us these tricks
looking also for your teaching about HFpEF diagnosis by RHC, fluid challenge test?

[@AliAli-wb3vl]

Thank you very much, the best Explanation i ever saw. Your Book und Your Video are very Good. I envy your Students. Best Regards

[@mirhansyahperdana7113]

Very nice presentation. I have a question. I had a patient with symtom of right heart failre. I did echo and i found typical finding of amyloidosis but also he had large pericardial effusion. I found mitral inflow variation > 25%. I wonder what was the couse of his symtom, was it rcm or pericardial prossess? Thank u sir

[@abdullahlsharaf2264]

Thank you, great. Can you please explain what would happen after PVC for pericarditis constrictiva? and should man induce PVC in Inspiration or in Expiration, does it make difference? I know it in HOCM, here the preload increases (would decrease the gradient), but the contractility increases and yet increases the gradient. Thanks again.

[@eliashanna8248]

PVC would exaggerate the LV-RV discordance. Normally, and in cardiomyopathies, stroke volume rises after a PVC in both ventricles with no dramatic discrepancy. Conversely, in constriction, the preload of one ventricle rises as the preload of the other ventricle declines, as they are both fighting for room in a constrained space and must expand at the expense of each other (rather than outward). This is a key value of PVC in constriction analysis. The post-PVC discordance often exaggerates the respiratory discordance (may occasionally attenuate it, depending on the preload point of each ventricle on the Starling curve). It does not matter whether the PVC is in inspiration or expiration.
AF, on the other hand, is more confusing and may falsely introduce discordance without constriction, depending on the preload dependence of each ventricle.
I have tracings of this PVC process my other constriction Video: th-cam.com/video/0sXHIb1pjzs/w-d-xo.html