Right and left heart catheterisation (old)

Summary

Percutaneous interventional techniques now include treatment of patients with not only coronary but also structural heart disease. To excel at today’s practice of interventional cardiology the operator must be constantly alert during and after the procedure to alterations of the patient’s clinical findings, electrocardiographic and haemodynamic status. A full understanding of basic haemodynamics and their pathophysiological alterations is required to address critical situations occurring during coronary interventions as well as clarify the diagnosis of and percutaneous treatment for valvular and other structural heart disease conditions. This chapter will review the fundamentals of cardiac haemodynamics, including those of the most common structural heart disease entities encountered in practice. Complete reviews of haemodynamics in general and those specifically applicable to more complex conditions can be found elsewhere11. Kern MJ, Lim MJ, Goldstein JA (editors). Hemodynamic Rounds: Interpretation of Cardiac Pathophysiology from Pressure Waveform Analysis, 3rd ed. Hoboken (NJ): Wiley-Blackwell; 2009. Link.

Basic haemodynamics

All pressure waves of the cardiac cycle can be understood by reviewing the electrical and mechanical activity of the heart as shown on Dr. Wigger’s diagram (Figure 1). The timing of mechanical events, such as contraction and relaxation and the generation of transvalvular and ventricular...