Exertional dyspnoea in a 28-year-old woman

Clinical introduction A 28-year-old woman with a history of critical pulmonic stenosis, status postsurgical valvotomy and subsequent pulmonary valve replacement, presented to the cardiology clinic with 1 year of progressive exertional dyspnoea. She has a heart rate of 75 bpm and blood pressure of 110/55 mm Hg. Cardiac auscultation reveals a 1/6 systolic ejection murmur along the left sternum and an early 3/6 diastolic decrescendo murmur. A transthoracic echocardiogram is obtained (figure 1). Questions Which of the following would be most likely found during right heart catheterisation?Ratio of pulmonary to systemic blood flow (Qp:Qs) >1.5 Pulmonary vascular resistance >3 Wood units Right atrial pressure >10mm Hg Pulmonary artery systolic pressure >45mm Hg E. Pulmonary artery diastolic pressure <10mm Hg
Source: Heart - Category: Cardiology Authors: Tags: Congenital heart disease Source Type: research