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  #1  
Old 07-04-2011
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Heart how diastolic failure has normal left ventricular cavity?

How LVEDV is normal in diastolic failure?was solving a question and i didnt get it..
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Old 07-04-2011
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could you post the question?
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Old 07-04-2011
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The key with diastolic dysfunction is the reduced compliance despite of initial normal LVEDV. The following explains:

Diastolic dysfunction is characterized by elevated diastolic pressure in the left ventricle despite essentially normal/physiologic end diastolic volume or EDV. Histologic evidence supporting diastolic dysfunction demonstrates hypertrophy of the cardiomyocytes, increased interstitial Collagen deposition and/or infiltration of the myocardium. These influences collectively lead to a downhill spiral in distensibility of the myocardium. The ventricle then behaves as a balloon made from abnormally thick rubber. Despite filling with high pressure, the volume cannot expand adequately. If the heart cannot readily fill with blood following contraction, one of two things must follow; either the cardiac output becomes diminished or compensation ensues to increase the ventricular diastolic pressure to higher levels. When the left ventricular diastolic pressure is elevated, venous pressure in the lungs must also become elevated to maintain forward flow. Increased pulmonary venous pressure results in alveolar edema causing the patient to be short of breath. Phrased differently, left ventricular stiffness makes it more difficult for blood to enter from the left atrium. As a result, pressure rises in the atrium and is transmitted back to the pulmonary venous system thereby increasing its hydrostatic pressure and thus promoting pulmonary edema

http://en.wikipedia.org/wiki/Diastolic_dysfunction
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Old 07-04-2011
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Quote:
Originally Posted by bebix View Post
could you post the question?
A 45 year old caucasian male presents to your office with exertional dyspnea and easy fatigability.He has not seen a physician for 10 years and has no knowledge of any medical problem.He does not take any medications and admits to cigarette and alcohol use.BP=170/90 mmHg,HR=80 beats /minute.
There are bilateral lung crackles on physical exam.Which of the following set of laboratory findings would be most consistent with diastolicheart failure in this patient?
left Ventricular cavity Left Ventricular Ejection fraction LVEDP

1.Dilated deceased Increased
2.Dilated decreased Normal
3.Normal decreased Decreased
4.Normal decreased Increased
5.Normal Normal Increased
6.Dilated Normal Normal
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Old 07-04-2011
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Quote:
Originally Posted by struggle View Post
A 45 year old caucasian male presents to your office with exertional dyspnea and easy fatigability.He has not seen a physician for 10 years and has no knowledge of any medical problem.He does not take any medications and admits to cigarette and alcohol use.BP=170/90 mmHg,HR=80 beats /minute.
There are bilateral lung crackles on physical exam.Which of the following set of laboratory findings would be most consistent with diastolicheart failure in this patient?
left Ventricular cavity Left Ventricular Ejection fraction LVEDP

1.Dilated deceased Increased
2.Dilated decreased Normal
3.Normal decreased Decreased
4.Normal decreased Increased
5.Normal Normal Increased
6.Dilated Normal Normal
Left Ventricular cavity = Normal
Left Ventricular Ejection fraction = Normal
LVEDP = UP

just remember the LaPlace´s law:
wall stress directly proportional to ventricular pressure and ventricular radius; and inversely to wall thickness
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Old 07-05-2011
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[QUOTE=struggle;51431]A 45 year old caucasian male presents to your office with exertional dyspnea and easy fatigability.He has not seen a physician for 10 years and has no knowledge of any medical problem.He does not take any medications and admits to cigarette and alcohol use.BP=170/90 mmHg,HR=80 beats /minute.
There are bilateral lung crackles on physical exam.Which of the following set of laboratory findings would be most consistent with diastolicheart failure in this patient?
left Ventricular cavity Left Ventricular Ejection fraction LVEDP

1.Dilated deceased Increased
2.Dilated decreased Normal
3.Normal decreased Decreased
4.Normal decreased Increased
5.Normal Normal Increased


i think the ans
5 im considering that ejection fraction is normal to increased in diastolic dysfunction n due to increased resistance to diastolic filling the LVEDP must increase..... i believe its a case of chronic hyprtension with LV concertic hypertrophy
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