mgh156 8 360/0.476 1382400 19:35:22 09/10/1992 mgh156.dat 212 377(481)/mV 12 0 453 16468 0 ECG lead I mgh156.dat 212 397(-83)/mV 12 0 49 -10846 0 ECG lead II mgh156.dat 212 384(10)/mV 12 0 84 -14007 0 ECG lead V mgh156.dat 212 12.04(-1269)/mmHg 12 0 48 7294 0 ART mgh156.dat 212 19.52(-965)/mmHg 12 0 -932 14753 0 PAP mgh156.dat 212 20 12 0 -959 -2567 0 CVP off mgh156.dat 212 1000 12 0 94 -3741 0 Resp. Imp. mgh156.dat 212 1000 12 0 1110 31492 0 CO2 #: 41 : M : Congestive heart failure # PERTINENT HISTORY: # Severe mitral stenosis # Moderate mitral regurgitation # Aortic stenosis # s/p AVR and MVR 10 years earlier # PHARMACOLOGIC SUPPORT: # Dopamine @ 213 mcg/min # Epinephrine @ 2.1 mcg/min # Isuprel @ 2.5 mcg/min # GENERAL COMMENTS: # Hypothermic @ 91.9F # ELECTROCARDIOGRAPHIC DATA # UNDERLYING RHYTHM: # Normal sinus rhythm with incomplete right bundle branch block @ 90 bpm # ECG INTERPRETATION: # Rightward axis shift # Right ventricular strain # Left atrial enlargement # HEMODYNAMIC DATA: # ART: 100/50 (axillary) # PAP: 83/56 PCW: 30 (@ 17 min, 27 min, 41 min) # RAP: 15 # WAVEFORM PATTERNS: # V waves due to mitral regurgitation in PCW trace # Pulmonary hypertension # Anacrotic notch on arterial trace due to aortic stenosis # Pulsus paradox # TECHNICAL COMMENTS: # CVP and PAP on single transducer # CVP data inaccurate? medications infused simultaneously # Zero @ 9 min # CVP recording @ 14 min - 15 min # RESPIRATORY DATA: # RATE: 18 bpm # MODE OF VENTILATION: # Controlled