Pulmonary Vascular Resistance

[Kristin391]

Recently, I had a right heart catheterization because I had high pulmonary artery pressures with a drop in pulse oximetry with a stress echocardiogram.  Some of the data from the right heart catheteterization with exercise showed PA pressures of 54/26 with a mean of 40, mean wedge presure 40 with a V wave of 56, cardiac output and cardiac index by thermodilution method 6.80/3.49.  Cardiac output /cardiac index by Fick method 5.78/2.96. Pulmonary vascular resistance by Fick cardiac output 0 Wood units.  PA sat 56%, pulse ox 85%. What is the significance of the 0 Wood Units?  What is considered normal for the adult?  At rest it was .88 Wood Units, PA was 39/17 with a mean of 27, Wedge 21 with a V of 40, CO/CI 5.34/2.74, by Fick 6.81/3.49. IVC 73%, RZ 66%, Low RA 68%, RVV sat 65% PA sat 70%, room air pulse ox 95%.  This may be too difficult for me to understand but I am just wondering about the Wood units and what they mean.  How can PVR be 0 Wood units?

[Cleveland Clinic]

Kristin,

Dont be too overwhelmed by the details, especially the normal ones. Wood units are a standard of measurement used to convert pulmonary vascular resistance measured in metric scale to an uniform scalar.Once this conversion is done, the measurement is reported in wood units. Your PVR is equal to about 70.1 (dyne*sec)/cm5. To convert to Wood Units this number is divided by about 79, which gives you a number less then 1. It must of been reported as 0 by the computer. Either way a number around or less then one is normal.

The main abnormality in your numbers is the elevated wedge pressure, with prominant v waves, and pulmonary pressures. In the setting of normal lung resistance, this would appear to reflect the pressures in the left atrium and would be con

sistant with LV failure, mitral regurgitation or possibly a VSD. Trying to interpret these numbers without seing the tracings is like someone describing a fine wine to you without tasting it.

My primary concern however, would be one of those 3 initally. Given the drop in saturation, I think a VSD could be responsible or mitral regurgitation(I would assume this would have been seen on the surface echo). I would make sure you sit down with your cardiologist and go over the numbers and data carefully to come to a conclusion your happy with.

good luck

[DebbieDo]

could some please tell me what stenosis is...........im inquiring for a neighbor friend who have to have surgery right away.

[Kristin391]

Where is this stenosis?  Usually it means a narrowing such as spinal stenosis, Renal artery stenosis etc.  In the case of an artery, there is usually placque in the vessel that causes a narrowing and decrease blood flow through the area.

[Kristin391]

There are many things about my situation that are very strange.  No, there was no mitral regurgitation seen on the echos.  They do believe the problem is with the mitral valve.  My EF is around 50% and I do not have a septal defect that I know of.  I also do not have any lung disease that could account for the pulmonary pressures. I am being evaluated further and hopefully they will come up with a treatment plan.  Continuing to live like this is not acceptable and is not an option for me.

[ontherecord]

Hopefully the further evaluations prove to be useful and your doctors can come up with an effective plan of action.  However, many, many conditions which afflict the human body often put people in compromising sitautions, where they do not have much of a choice besides "living with it."  For example, half of all heart attacks cannot be explained by risk factors; this means you can control all your risk factors -- cholesterol, hypertension, regular exercise, smoke-free lifestyle, glass of red wine a night -- and still get an MI out of nowhere.  If you have a family history of CAD, then that's strongly predictive -- not much you can do.  People have to "live with" all sorts of things, ranging from macular degeneration to unremitting and insidious glaucoma, to Alheizmer's disease, vascular dementia, Huntington's, Parkinson's, CJD, ALS, cerebellar degeneration, and a thousand other conditions, ranging from neuropathy to chronic fatigue to constant pain, to chronic obsructive pulmonary disease to a variety of cancers and other ailments too exhaustive to list here.  Only point I'm trying to make is that a person's resolve has its limitations and certainly doesn't transcend the reality of many health conditions.

[ontherecord]

Or sometimes is means living while having an ailment that you just have to manage to deal with in some way or another.

Most of medicine is not about "healing" -- it's about MANAGING conditions.  Most conditions are primarily *managed* by doctors more than they are treated per se.  Today, due to advances in modern medicine, people are living LONGER, but it doesn't mean they are living BETTER.  For example, 700,000 Americans have a stroke every year, 75% live, and 9 out of 10 have permanent deficits thereafter.  Some can't walk, some can't talk, and others wind about developing multi-infarct dementia, another thing you just have to live with (if you want to live at all).  Many experts in neurology believe that Alzheimer's disease is the price we pay for increased life expectancy, evinced by the fact that after the age of 65, your chances of developing AD rise exponetially.  20% of all people over 80 have it.  Living into one's 70's today often comes at a high price -- both to the healthcare system and to the person living it -- not just in monetary costs, but in human costs, both tangible and intangible.  

I'm 26, but based on what I know on the struggles of the elderly, both in human costs and financial costs, and some of the progressive and deteriorating illnesses they face, either they'd better find a cure for many of these afflictions by the time I get old, or let people die with dignity if they choose to do so.  Visit your local nursing home and see how those people live, and you'll no longer have a doubt in your mind.

[Kristin391]

I was just saying that I am pursuing all options to find and repair my problems.  My problems, I believe, are mechanical and can be repaired.  To continue as I am is not an option for me.  I can and want to return to full health.  That is all I was saying.   I do not have health problems that are not fixable...that is what I am saying.  It is a matter of identifying the causes and developing a solution and plan to fix the problems.  Hope that clarifies my situation.

[ontherecord]

Thanks for the clarification.  Good luck getting to the bottom on your condition and best wishes for a full recovery.

[Ally458]

A related discussion, Pulse Pressure & PVR was started.