Question

Pulsed-wave Doppler evidence of cardiac tamponade includes:

A. Systolic flow reversal in the pulmonary veins
B. Systolic flow reversal in the hepatic veins
C. Insipiratory increase in peak velocity across the mitral valve with an inspiratory decrease in peak velocity across the tricuspid valve
D. Inspiratory decrease in velocity across the mitral valve with an inspiratory increase in velocity across the tricuspid valve

Answer 1

In cardiac tamponade, the pulsed-wave Doppler ultrasound finding is an inspiratory decrease in velocity across the mitral valve alongside an inspiratory increase in velocity across the tricuspid valve, reflecting impaired cardiac filling dynamics.

Step-by-step explanation:

Pulsed-wave Doppler ultrasound is a valuable tool in diagnosing conditions like cardiac tamponade. This condition leads to distorted hemodynamics within the heart. When considering pulsatile flow in patients with cardiac tamponade, one would expect to see inspiratory changes in the velocity of blood flow across the heart valves, indicative of changing intracardiac pressures with respiration due to the impeded cardiac filling. The specific finding associated with tamponade is an inspiratory decrease in velocity across the mitral valve with an inspiratory increase in velocity across the tricuspid valve. This reflects the increased difficulty that the right side of the heart faces in accommodating venous return during inspiration when intrapericardial pressures are pathologically high.