Left ventricular diastolic dysfunction in echocardiography

Left ventricular diastolic dysfunction in echocardiography

1. Left Ventricular Diastolic Dysfunction Name : Yukta Wankhede PRN: 17040121108 Programme: B Sc. MT Cardiac Care Technology Batch: 2017-2020

2. Definition Dia s tolic dysfunction is the condition in which the cardiac muscles are unable to relax/ diastole to fill ventricle to attain a normal end-diastolic volume without an inappropriate increase in LV end-diastolic pressure (LVEDP).

3. Etiology Primary Myocardial di seases Hypertrophic cardiomyopathy Restrictive cardiomyopathy D ilated cardiomyopathy Hypertension Secondary Hypertrophy Aortic Stenosis Congenital Heart Disease Coronary Artery Disease Ischemia Infraction Extrinsic Constrain Pericardial Tamponed Constrictive Pericarditis

4. Anatomical Bases 2D : PLAX Apical-4-Chamber View Doppler Colour Doppler Flow Bases : PWD Mitral valve pattern Pulmonary vein pattern Tissue Doppler Imagining Mitral Annular Velocity Method of Evaluation of LVDD

5. Anatomical B a ses In 2D LV mass and dimensions LV hypertrophy is the commonest cause of diastolic dysfunction Relative wall thickness LA volume and LA volume index

6. Grade s of LVDD Grade I : (a) Impaired relaxation pattern with NORMAL FILLING pattern. (b) Impaired relaxation pattern with INCREAED FILLING pattern. Grade II : PSEUDONARMALIZATION PATTERN Grade III : REVERSIBLE RESTRICTIVE PATTERN Grade IV : IRREVERSIBLE RESTRICTIVE PATTERN

7. E A IVRT LV LA PW Doppler AC MO MC Mitral Valve Inflow Velocity Pulse Wave Doppler Signal

8. Pulmonary Venous F low Pattern S : Systolic velocity D: Diastolic velocity AR : Atrial Reversal velocity

9. Tissue Doppler Imaging Mitral Annular Motion S : Systolic velocity E’ : Early diastolic velocity A’ : Late diastolic velocity

10. CASE STUDY An 88-year-old Japanese man presented to our emergency unit in a comatose condition with a body temperature below the lower limit of detection (<32°C when measured under the armpit; <34°C when measured at the tympanic membrane) and no external injures. An electrocardiogram performed on admission showed sinus arrest and junctional rhythm with a heart rate of 40 beats per minute. Osborn waves were apparent in leads V4 to V6.

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