Hemodynamic Rounds: Interpretation of Cardiac Pathophysiology from Pressure Waveform Analysis

The essential resource on cardiac hemodynamics now in a new edition

Hemodynamic Rounds, Fourth Edition is intended to help cardiologists, cardiovascular fellowship trainees, residents and other members of the medical community enhance their understanding of cardiac physiology and its associated hemodynamic presentations in health and disease. This includes the basic principles of flow and pressure measurements, systemic as well as coronary hemodynamics in normal and diseased states, and changes in hemodynamics following interventional procedures ranging from TAVI and valvuloplasty to stent placement.

Like its popular predecessors, this new edition draws on case studies to illustrate characteristic cardiac hemodynamic findings and discusses the essential methods used in interpreting pressure waveforms as a diagnostic and monitoring tool.

The text is organized into chapters on specific areas of the heart, common cardiac pathophysiologic conditions, and hemodynamic situations resulting from different therapeutic procedures. It includes discussions of both normal and abnormal pressure waveforms. This new edition has been revised throughout to include brand new content on aortic and mitral valve stenosis and regurgitation as well as TAVI and mitral clip hemodynamics. Highlights include:

Essential and easy to understand resource for those required to interpret cardiac blood flow and blood pressure tracings Covers hemodynamic assessment by cardiac disorder, plus the bedside applications of hemodynamics Revised throughout and includes brand new content on valve stenosis and regurgitation and TAVI and mitral clip hemodynamics

Hemodynamic Rounds: Interpretation of Cardiac Pathophysiology from Pressure Waveform Analysis, Fourth Edition is an indispensable tool for all physicians, nurses, and students responsible for measuring and interpreting cardiac waveforms in cardiac diagnosis and monitoring.

List of Contributors ix

Preface to the Fourth Edition xi

Introduction xiii
Morton J. Kern and James A. Goldstein

Part One Normal Waveforms 1

1 Principles of Normal Physiology and Pathophysiology 3
James A. Goldstein and Morton J. Kern

2 Left Atrial Hemodynamics 35
Morton J. Kern

3 Left Ventricular End ]Diastolic Pressure (LVEDP) 43
Morton J. Kern

4 Left and Right Ventricular Pressure: Interactions and Influencing Factors 49
Morton J. Kern

5 Hemodynamics during Arrhythmias 67
Morton J. Kern, Thomas J. Donahue, and Richard G. Bach

Part Two Valvular Hemodynamics 79

6 Aortic Stenosis 81
Michael J. Lim and Morton J. Kern

7 Aortic Regurgitation 101
Morton J. Kern and Michael J. Lim

8 Mitral Valve Stenosis 119
Morton J. Kern and Michael J. Lim

9 Multivalvular Regurgitant Lesions 143
Morton J. Kern

10 The Pulmonary Valve 159
Morton J. Kern

11 Hypertrophic Obstructive Cardiomyopathy (HOCM) 165
Morton J. Kern

Part Three Constriction and Tamponade 195

12 Introduction to Pericardial Disease 197
James A. Goldstein

13 Restrictive Cardiomyopathy: Differentiating Constrictive Pericarditis and Restriction 219
James A. Goldstein

14 Hemodynamic Manifestations of Ischemic Right ]Heart Dysfunction 235
James A. Goldstein

Part Four Hemodynamics of Structural Heart Disease 249

15 Percutaneous Balloon Aortic Valvuloplasty and Transaortic Valve Replacement 251
Williams M. Suh, Morton J. Kern, and Zoltan Turi

16 Percutaneous Balloon Mitral Valvuloplasty 275
Morton J. Kern, Paul Sorajja, and Zoltan Turi

17 The Pulmonary Valve and Valvuloplasty 295
Morton J. Kern

Part Five Coronary, Renal, Congenital, and Left Ventricular Support Hemodynamics 309

18 Coronary Hemodynamics: The Basics of Pressure and Flow Measurements, Coronary Vasodilatory Reserve, and Fractional Flow Reserve 311
Morton J. Kern and Crystal Medina

19 Renal Artery Stenosis 349
Morton J. Kern

20 Adult Congenital Anomalies 361
Morton J. Kern, Ralf J. Holzer, and Ziyad M. Hijazi

21 Extra Hearts: Unusual Hemodynamics of Heterotopic Transplant and Ventricular Assist Devices 379
Morton J. Kern

22 Invasive Hemodynamic Assessment of Shock and Use of Mechanical Support for Acute Left and Right Ventricular Failure 401
Ivan D. Hanson and James A. Goldstein

Part Six Clinical and Bedside Applications of Hemodynamics 409

23 An Anatomic ]Pathophysiologic Approach to Hemodynamic Assessment 411
James A. Goldstein

Appendix: Hemodynamic Rounds, Fourth Edition, 2018 427

Index 431

MORTON J. KERN, MD, MFSCAI, FAHA, FACC, Chief of Medicine, Veterans Administration Long Beach Health Care System; Professor of Medicine, University of California, Irvine, CA, USA.

MICHAEL J. LIM, MD, Chief of Cardiology, St. Louis University, St. Louis, MO, USA.

JAMES A. GOLDSTEIN, MD, Director, Cardiovascular Research, William Beaumont Hospital, MI, USA.