Lecture 2.1b - Interpreting Wiggers Diagram PDF
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Aston University
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Summary
This document provides an explanation and interpretation of Wigger's diagrams, focusing on the waveforms associated with arterial and central venous pressure. The lecture notes cover various phases of the cardiac cycle and discuss how to interpret related waveforms. It includes details about the role of different valves and pressures involved in the process.
Full Transcript
Patient monitor: Arterial lines: ◦Continuous monitoring of blood pressure ◦Access sites: radial, brachial, femoral, tibial arteries (radial and femoral most common due to their easy accessibility) ◦Allows continuous monitoring of: ‣ Blood pressure (real-time readings)...
Patient monitor: Arterial lines: ◦Continuous monitoring of blood pressure ◦Access sites: radial, brachial, femoral, tibial arteries (radial and femoral most common due to their easy accessibility) ◦Allows continuous monitoring of: ‣ Blood pressure (real-time readings) ‣ Pulse rate and rhythm ‣ Effects of dysrhythmia on perfusion ‣ Measurement of cardiac output, SV ‣ Specific wave form morphologies might be diagnostic Central venous lines: ◦Swan-Ganz catheters ◦Access sites: right jugular vein (or left), subclavian vein, femoral vein ◦Allows continuous monitoring of: ‣ Right atrial pressure (and right-sided preload) ‣ Central venous pressure ‣ Infuse fluids of medicines (chemotherapy) ‣ Specific wave form morphologies might be diagnostic Wiggers diagram: ◦QRS complex shows ventricular contraction - atrial repolarisation is masked by the QRS wave. ◦T wave shows ventricular repolarisation. Wiggers diagram: Atrial systole: Wiggers diagram: Isovolumetric contraction: Mid-to-late ventricular systole: Rapid ejection: Mid-to-late ventricular systole: reduced ejection: Early ventricular diastole/isovolumetric relaxation: Arterial waveform: ◦Aortic valve closes shut; induces pressure on aortic valve more, causing the dicrotic notch ◦Mean arterial pressure (area under the curve) - 2/3 diastole + 1/3 systole ◦Pulse pressure - difference between systolic and diastolic blood pressure (usually about 40 mmHg) - gives the right amount of perfusion ◦Aortic regurgitation - increase in stroke volume, systolic blood pressure increases and so pulse pressure widens ◦Narrow pulse pressure occurs in heart failure, or stenosis Central venous pressure waveform: ◦A wave - atrial contraction ◦C wave - tricuspid valve closure - creates a backward push into the vena cava ◦X descent - atrial relaxation - pressure decreases ◦V wave - venous filling ◦Y descent - emptying of right atrium
