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Attempting to reply two informal queries on RV dysfunction

by HealthMatters August 5, 2024, 12:19 am 1.9k Views

Attempting to reply two informal queries on RV dysfunction

August 3, 2024 by dr s venkatesan

1.What’s the response of RV to stress overload ?

A. Dilatation

B. Hypertrophy

C Each happen collectively

D. Hypertrophy is the Preliminary response, adopted by dilatation

Reply :

Since we consider RV’s conduct is usually reverse to that of LV , many would tick, dilatation as the primary response. This can be right when there may be acute elevate in RV after load, as in PE. Nevertheless, It’s shocking even in persistent pulmonary hypertension , the diploma of RVH just isn’t fixed and homogenous .It’s because , totally different components of RV chamber has totally different wall thickness .Additional, the stress distribution from PA to RV is uneven. The co-existing TR confounds the loading situations. It isn’t but clear, how the RV would reply to raised PA stress. Within the mattress aspect, we’re seeing each flight(dilate) ot combat (RVH) reactions from RV (extra usually the previous than the later) It’s attainable RV conduct is be pre-programed and constructed into the genes of the contractile proteins.

It’s worthwhile to notice, RVH is fixed characteristic in non pulmonary hypertension associated “after-load” situations as in valvular or sub valvular PS. That is extra to do failure of regression of RV mass early after delivery, reasonably than the precise impact of excessive after load. One other level is only technical. RVH is measured in RV free wall, in subcostal view in diastole and inspiratory part.(higher restrict is 4mm) Many people may miss RVH in routine echocardiography until particularly regarded for.

2.Which is the primary echocardiographic parameter to get impaired when RV fails ?

A. RV FAC (Fractional space change)

B.TAPSE

C. RV Ejection fraction

D.RV longitudinal pressure

E. RV S‘

Reply : I’m not very positive about the best reply , however TAPSE is final to get Impaired .(Nonetheless, we have a good time it like something is a special story) Many consider transverse practical Indices like FAC is impaired early. and is much less influenzed by the spurious spill over of Left ventricular contractile pressure in transannular airplane (Which augments longitudinal practical Index like TAPSE),

The next illustration (From Ref 2 ) summarizes all RV practical parameter in a succinct trend. Fellows have to be acquainted with at-least half of them.( RIMP is much less sensible and error inclined will be ignored)