TABLE 30–7.

Underestimation of Left Ventricular End-Diastolic Pressure

SITE OF
CONDITION CAUSE OF DISCREPANCY
DISCREPANCY

Decreased left ventricular

Mean LAP<LVEDP Increased end-diastolic a wave
compliance

Mitral valve closure prior to end-

Aortic regurgitation LAP a wave<LVEDP
diastole

Bidirectional runoff for pulmonary

Pulmonic regurgitation PADP<LVEDP
artery flow

Right bundle branch block PADP<LVEDP Delayed pulmonic valve opening

Decreased pulmonary Obstruction of pulmonary blood

PAWP<LVEDP
vascular bed flow
 TABLE 30–8. Overestimation of Left Ventricular End-Diastolic Pressure

SITE OF
CONDITION CAUSE OF DISCREPANCY
DISCREPANCY

Positive end-expiratory Mean PAWP>Mean Creation of lung zone 1 or 2 or

pressure LAP pericardial pressure changes

Pul arterial HTN PADP>Mean PAWP  pulmonary vascular resistance

Pulmonary veno- Mean PAWP>Mean Obstruction to flow in large pulmonary

occlusive disease LAP veins

Mitral stenosis Mean LAP>LVEDP Obstruction to flow across mitral valve

Retrograde systolic v wave raises mean

Mitral regurgitation Mean LAP>LVEDP
atrial pressure

Ventricular septal Antegrade systolic v wave raises mean

Mean LAP>LVEDP
defect atrial pressure
 TABLE 30–8. Overestimation of Left Ventricular End-Diastolic Pressure

SITE OF
CONDITION CAUSE OF DISCREPANCY
DISCREPANCY

PADP>Mean Short diastole creates pulmonary

Tachycardia
LAP>LVEDP vascular and mitral valve gradients