Question

A patient with chronic systemic hypertension presents to the echocardiography laboratory. The following pulsed-wave Doppler data is acquired from the tips of the mitral valve leaflets: E:A ratio 1.2:1, deceleration time 210 msec, isovolumic relaxation time 83 msec, and pulmonary vein reversal 46cm/sec. The Doppler data indicates diastolic filling stage:

A. I
B. II
C. III
D. IV

Answer 1

The Doppler data for a patient with chronic systemic hypertension indicates a diastolic filling stage I, consistent with grade I diastolic dysfunction or impaired relaxation of the ventricles.

Step-by-step explanation:

The patient with chronic systemic hypertension and the provided Doppler data exhibits a diastolic filling pattern consistent with diastolic filling stage I (grade I diastolic dysfunction or impaired relaxation), which equates to diastolic dysfunction in the context of this question. The E:A ratio of 1.2:1 indicates a normal filling pattern where early diastolic filling (E wave) is slightly higher than late diastolic filling (A wave), suggesting that the ventricle fills mostly during early diastole. The deceleration time of 210 msec and isovolumic relaxation time (IVRT) of 83 msec suggest a mild delay in relaxation of the ventricle, which are also consistent with impaired relaxation or grade I diastolic dysfunction. However, the pulmonary vein reversal speed of 46 cm/sec does not correspond to this stage directly and would typically be consulted in context with other findings to assess the severity of diastolic dysfunction.