Final The Echo Manual DIGITAL

The Echo Manual

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CHAPTER 12 PERICARDIAL DISEASES

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FIGURE 12-28 A: M-mode shows interventricular dependence, pulsed wave Doppler recording of mitral inflow velocity showing respiratory variation ( upper right ), and the medial e ′ velocity is 9 cm/s in a 23-year-old woman with asthma. Those findings are all consistent with constriction. However, IVC flow is markedly increased with inspiration ( arrows in lower right ) indicating increased respiratory effort. Similar Doppler findings can be found in individ- uals with augmented respiratory effort. B: Left , Pulsed wave Doppler record- ing from the superior vena cava ( SVC ) in a patient with increased respiratory effort showing a marked increase in forward flow velocity with inspiration, which is almost monophasic ( arrow ) and a marked diminution of forward flow along with prominent reversal flow with expiration. Right , SVC flow from con- strictive patient shows no significant change in systolic forward flow velocity with respiration due to increased right atrial pressure, which is not affected by inspiratory intrathoracic pressure drop. D , diastolic flow; DR , diastolic flow reversal; S , systolic flow; Exp , expiration; INSP , inspiration. :ROW

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