Combined Mitral and Pulmonic Stenosis
A case of combined pulmonic and mitral stenosis with cardiac catheterization studies is presented. A modification of the formula for calculating pulmonic valvular resistance is discussed. The importance of calculating cardiac output on the basis of the systolic ejection phase is noted.
The pulmonic valvular resistance by this modified formula was 210 dynes seconds cm.-5 The pulmonary vascular resistance was 250 dynes seconds cm.-5 The pulmonic valvular resistance tended to protect against the development of pulmonary edema, much as a high pulmonary vascular resistance protects against pulmonary edema.
The right ventricular output, which was 1.6 L. per minute, was limited by the pulmonic stenosis. Other mechanisms that might mechanically limit right ventricular output are significant tricuspid stenosis or limb tourniquets. In situations of impending pulmonary edema, any one of these factors that decrease right ventriccular output may be advantageous.
- © 1957 American Heart Association, Inc.