3 years ago

Exertional dyspnoea in a 28-year-old woman

Clinical introduction

A 28-year-old woman with a history of critical pulmonic stenosis, status postsurgical valvotomy and subsequent pulmonary valve replacement, presented to the cardiology clinic with 1 year of progressive exertional dyspnoea. She has a heart rate of 75 bpm and blood pressure of 110/55 mm Hg. Cardiac auscultation reveals a 1/6 systolic ejection murmur along the left sternum and an early 3/6 diastolic decrescendo murmur. A transthoracic echocardiogram is obtained (figure 1).

Questions

Which of the following would be most likely found during right heart catheterisation?

  • Ratio of pulmonary to systemic blood flow (Qp:Qs) >1.5

  • Pulmonary vascular resistance >3 Wood units

  • Right atrial pressure >10mm Hg

  • Pulmonary artery systolic pressure >45mm Hg E. Pulmonary artery diastolic pressure <10mm Hg

  • Publisher URL: http://heart.bmj.com/cgi/content/short/103/22/1779

    DOI: 10.1136/heartjnl-2017-312174

    You might also like
    Discover & Discuss Important Research

    Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

    • Download from Google Play
    • Download from App Store
    • Download from AppInChina

    Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.