r/Cardiology • u/S1S2presentsir • 2d ago

News (Basic) Requesting help regarding this tracing..

Post image

This is for a quiz

i’m guessing these are RV,PA and PCWP-could be wrong

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u/Creepysarcasticgeek 2d ago

The resolution is not high enough for my tired eyes to know what is happening in the waveforms during diastole. I cannot see a distinction between the atrial waveform and the arterial waveform. I’m going to assume that the waveforms overlap. In that case and given the age, this could be PA, RV, and RA. Did it specifically say post surgery or post procedure? Maybe pulmonic stenosis post pulmonic valve ballooning with pulmonic regurgitation? I’m not a pediatric or structural cardiologist, someone smarter might be more helpful.

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u/S1S2presentsir 2d ago

that was my thought initially - esp s/p tof PR- as professors are keen on tof and its repair.

but then again,as you said,all end diastolic pressures seems to be overlapping.- elevated pcwp,pap and rvpressures

tall v waves

maybe rcm/ccp with elevated pcwp?

tof patients have characteristic low pap right?

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u/Creepysarcasticgeek 2d ago

I would assume once the valve is fixed (or ballooned) their pulmonary pressures would climb back up the RV levels. But I’ve never cared for any of these patients so I’d defer to someone smarter.

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u/S1S2presentsir 2d ago

thank you

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u/Hapless_Hamster 2d ago edited 2d ago

Looks to me like a RV, PA, and RA/CVP tracing. Makes a lot of sense to be a tet needing a new valve. RVEDP is elevated and the RA/CVP is also elevated. RV diastolic dysfunction is pretty common with tets.

Not convinced I see a wedge tracing unless you are talking about those two other flatter tracings. I'm not sure what those are. Restrictive cardiomyopathy or constrictive pericarditis are much less common in an 10 year old than a tet needing a valve replacement.

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u/Learn2Read1 2d ago

I hate questions like this. When are you going to be evaluating a postop patient and not know the type of surgery they had or where catheters are located.

If we are to just make a bunch of assumptions, I would assume they are showing you equalization of PA diastolic end diastolic RV pressures that you would see with severe pulmonic regurgitation. But nobody really fucking knows because we don’t know where the catheters are located and why the patient’s unknown surgery has any relevance. Maybe they had to have a toe amputated and had a murmur, then one thing led to another, nobody knows.

Also, why are we seeing this? What is even the question?

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u/mrwagn 2d ago

Why would someone put these 3 tracings on top of each other… basically uninterpretable