A 57-year-old woman with myxomatous mitral valve degeneration presents with dyspnea on exertion. Vital signs show BP 138/72 mmHg, HR 88/min, RR 18/min, SpO2 98% on room air. Echocardiography reveals severe mitral regurgitation with left ventricular enlargement and ejection fraction of 50%. She denies chest pain. She takes lisinopril and metoprolol. Compared with a normal heart, which of the following changes would most likely be seen on her left ventricular pressure-volume loop?
- A)No change in end systolic volume or diastolic filling
- B)Loss of isovolumetric phases with increased end diastolic volumeGABARITO
- C)Leftward shift due to reduced preload
- D)Increased isovolumetric contraction and reduced end diastolic volume
- E)Markedly increased afterload with reduced stroke volume only
Explicação
Loss of isovolumetric phases with increased end diastolic volume is correct. In mitral regurgitation, blood can flow backward into the atrium during systole and forward into the ventricle from the atrium during diastole, so the isovolumetric contraction and re... Ver explicação completa e trilha adaptativa →