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Effect of Blood Volume
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Effect of Blood Volume

I am a RN, age 49, female, 5
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74076_tn?1189759432
Hi dionna,

Changes in blood volume is not handled the same in a normal versus diseased heart.  Normal hearts tend to take changes in blood volume very well, whereas the contrary is not ture.

1. valvular regurgitation?

Decreased blood volume, decreased blood pressure tends to decrease regurgitation.  It is common to take someone to the operating room for severe mitral regurg and find moderate MR after sedation (decreased blood pressure decreases MR).  Increased blood pressure and increased blood volume increase MR.  An acute exacerbation of heart failure is likely to find increased regurgitant fractions because of the increased heart pressures.


2. dimensions of heart chambers?

This is not that affected by volume changes.


3. ejection fractions

A normal heart will have increased ejection fraction with hypovolemia.  The ejection fraction would stay the same with hypervolemia.

A cardiomyopathy my have decreased heart function with hypervolemia and may also have an increased ejection fraction with hypovolemia.  

Take this with a grain of salt because the curves for pressure volume loops break down with too much or too little preload.    do a google image search for Frank Starling mechanism or Frank Starling curve.

4. pulmonary arterial pressure, (systolic, diastolic, mean)


In a normal heart there is little effect on pulmonary pressures.  Pulmonary pressures in a cardiomyopathy or with valvular disease can increas substantially with hypervolemia.  On the echo this is reported as right ventricular systolic pressure (RVSP).

5. aortic root size / size of aorta

blood volume should have no effect on these measures.

I hope this helps.  Good luck and thanks for posting.
2 Comments
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Avatar_n_tn
Thank you for taking the time to answer my questions and explain so thoroughly.  I appreciate your help in understanding these effects of blood volume variations.
Dionna
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Avatar_m_tn
Have you considered getting a TEE? Being in the medical field you know that adults and people who are overweight sometimes have poor image quality on their echos if done the standard way.
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