Right and left ventricular volume characteristics in children with pulmonary stenosis and intact ventricular septum

Circulation
|May 1, 1976
PubMed

Insights

In patients with isolated pulmonary stenosis (PS), right and left ventricular function are normal. However, PS with a right-to-left atrial shunt indicates depressed ventricular function, necessitating RV volume assessment for management.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Echocardiography

Background:

  • Pulmonary stenosis (PS) is a common congenital heart defect.
  • Assessing ventricular function is crucial for managing PS patients.
  • Distinguishing isolated PS from PS with shunts is important for treatment.

Purpose of the Study:

  • To evaluate right ventricular (RV) and left ventricular (LV) volume variables in patients with PS.
  • To compare ventricular function in isolated PS versus PS with a right-to-left atrial shunt.
  • To determine the clinical utility of RV volume assessment in PS management.

Main Methods:

  • Cardiac catheterization was performed on 27 patients with PS.
  • Patients were divided into isolated PS (group I) and PS with shunt (group II).
  • RV and LV volumes were calculated using Simpson's rule and area-length methods.

Main Results:

  • In isolated PS, RV ejection fraction was normal, but RVEDV/LVEDV ratio was reduced.
  • RV end-diastolic volume decreased with age and obstruction severity in isolated PS.
  • In PS with shunt, RV and LV volumes showed depressed function, despite normal RV ejection fraction.

Conclusions:

  • Ventricular function is generally normal in children with isolated PS.
  • RV volume assessment is not essential for managing isolated PS.
  • PS with a right-to-left atrial shunt shows signs of depressed ventricular function, making RV volume quantitation helpful for management.

Related Concept Videos

Anatomy of the Heart01:27

Anatomy of the Heart

The human heart is made up of three layers of tissue that are surrounded by the pericardium, a membrane that protects and confines the heart. The outermost layer, closest to the pericardium, is the epicardium. The pericardial cavity separates the pericardium from the epicardium. Beneath the epicardium is the myocardium, the middle layer, and the endocardium, the innermost layer. There are four chambers of the heart: the right atrium, the right ventricle, the left atrium, and the left ventricle.
Chambers of the Heart01:16

Chambers of the Heart

The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
Deoxygenated blood from the body is received in the right...
Gross Anatomy of the Lungs01:17

Gross Anatomy of the Lungs

The lungs are a pair of vital organs connected to the trachea via the left and right bronchi. The base of these organs meets the dome-shaped muscle known as the diaphragm. Encased by the pleurae, the lungs contact the mediastinum. The right lung is shorter yet wider, and has a larger volume than the left lung. The left lung has an indentation known as the cardiac notch. The superior region of the lungs is referred to as the apex, whereas the base is the lower region near the diaphragm. The...
Anatomy of the Heart01:20

Anatomy of the Heart

The heart is a hollow, muscular organ approximately the size of a fist, consisting of four chambers. It is enclosed in the pericardium, a fibrous sac with two layers: the visceral and parietal pericardium, separated by a fluid-filled space containing serous fluid to reduce friction.
The heart has three layers: the innermost endocardium, the muscular myocardium, and the outer epicardium, all working together for optimal cardiac function.
Chambers of the Heart
The heart is made up of four...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...