BAMC 3804 Hemodynamic Response to Amyl Nitrite Inhalation скачать в хорошем качестве

BAMC 3804 Hemodynamic Response to Amyl Nitrite Inhalation

Hemodynamic Response to Amyl Nitrite Inhalation (BAMC #3804) PAO Approval: 03.15.2022 This video was produced for teaching purposes only. Hemodynamic waveforms were obtained from the digitization of an FM tape recording from the Cardiac Catheterization Laboratory at Brooke Army Medical Center that were originally recorded between 1973 and 1992. Digitized recordings were rescaled from the original calibration signals recorded on the FM tape. This video presents simultaneously recorded right and left heart hemodynamic changes associated with the inhalation of amyl nitrite (3 deep breaths) in a subject without heart disease. The total time recorded was 75 seconds. Three different display formats were used to demonstrate hemodynamics during this period. It is anticipated that instructors may use one or more of these sequences to complement their instruction. For students viewing this video without the benefit of an instructor, it is recommended to consult standard textbooks or PubMed reviews for additional information. A link is provided below for published information related to this case. Video Sequence 1: In the first video changes in aortic velocity (Ao Vel) are demonstrated with ECG, aortic (AoP) and pulmonary artery (PAP), right atrial (RAP) and pulmonary capillary wedge pressure (PCWP). Mean trend lines in AoVel and AoP are also presented in white. (Means were derived from the applications of a 0.3 Hz lowpass Bessel 6 pole filter to duplicated (dup) AoP and PAP waveforms). Video Sequence 2: The second sequence compares changes in high-fidelity right heart pressures (PAP, RVP, and RAP) with high-fidelity left heart pressures (AoP and LVP) and a fluid PCWP. Video Sequence 3: The third sequence illustrates the range of variability in the instantaneous left ventricular-aortic pressure gradient (LVP-AoP) in a patient without left ventricular outflow tract obstruction following amyl nitrite inhalation. The LVP-AoP gradient was derived by the subtraction of digital waveforms, however, at the time of the original catheterization this gradient was displayed in real-time using an analog subtraction circuit but was not recorded on FM tape. Respiratory effort is depicted in each sequence at the bottom of the lower channel. Respiratory effort was recorded with a pneumatic belt. In this recording inspiration is a downward and expiration an upward deflection. All pressures except for the R Fluid pressure depicted in yellow were derived from high-fidelity, multisensor catheters. Labels to the right of the waveform display indicate catheter sensor locations. The high-fidelity multisensor left heart catheter had a pressure sensor at distal tip (L Dist) and a sensor 5 cm from the distal tip (L Prox). An electromagnetic velocity sensor (L Vel) was co-located with the proximal pressure sensor. The multisensor right heart catheter had three pressures sensors: a distal sensor (R dist) behind a dummy tip (non-sensing extension) that stabilized the catheter in the pulmonary artery, a middle sensor (R mid) for measuring right ventricular pressures and a proximal (R prox) sensor for recording right atrial pressures. Colored numerical values to the right of sensor location labels indicate mean values for physiological variables and are updated periodically in the real-time displays. Link to related published work for this case: https://pubmed.ncbi.nlm.nih.gov/8096167/ For additional information about the High-Fidelity Hemodynamic Waveform Library at Brooke Army Medical Center, contact the Cardiology Service, Brooke Army Medical Center, Fort Sam Houston, Texas. MLA citation for this video: “BAMC 3804 Hemodynamic Response to Amyl Nitrite Inhalation.” YouTube, uploaded by HemodynamicRounds, 1 Apr. 2022,    • BAMC 3804 Hemodynamic Response to Amyl Nit...  .