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BAMC 3318 Hemodynamic Response to Isoproterenol Infusion

Hemodynamic Response to Isoproterenol Infusion: Comparisons with Rest and Exercise Hemodynamics (BAMC #3318) PAO approval: 04.21.2022 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. It is anticipated that instructors may use one or more of the sequences presented in this video to complement their instruction. Videos may be paused to allow more time for content review. For students viewing this video without the benefit of an instructor, it is recommended to consult standard textbooks or PubMed reviews for additional information. Case Information: This patient was a active duty 34 year-old male who was referred for cardiac catheterization to rule out heart disease for fitness for duty. Case Comments: Isoproterenol is a potent agonist for beta-1 and beta-2 adrenergic receptors. This case demonstrates the chronotropic, inotropic, and vasodilator effects of isoproterenol and compares these changes to changes during supine submaximal exercise at similar heart rates. In this patient heart rate after exercise stabilization (2170 fpm) was 138 bpm compared with 136 bpm during isoproterenol infusion at (0.8 mcg/min). Cardiac output increased 80% with exercise and 58% with isoproterenol. Mean pulmonary artery pressure (PAP) increased 12 mmHg during exercise and 5 mmHg with isoproterenol. Mean aortic pressure (AoP) increased 11 mmHg with exercise and decreased 13 mmHg during isoproterenol infusion. The A-VO2 gradient was 2.9 vol% at rest, increased to 7.6 vol% during exercise and decreased to 2.4 vol% during isoproterenol. Systemic vascular resistance decreased 34% during exercise and 44% with isoproterenol. In this patient without evidence of significant cardiovascular disease, left ventricular end-diastolic pressure was 11 mmHg at rest, 10 mmHg during exercise and 3 mmHg during isoproterenol infusion. [Data from original catheterization report.] MLA citation for this video: “BAMC 3318 Hemodynamic Response to Isoproterenol Infusion.” YouTube, uploaded by HemodynamicRounds, 21 Apr. 2022,    • BAMC 3318 Hemodynamic Response to Isoprote...  .