AI Snips
Chapters
Transcript
Episode notes
Dyspnea Often Is The Presenting Ischemic Symptom
- In stress tests, many patients with coronary ischemia report dyspnea instead of chest pain.
- Tony Brew highlights a 1968 study where 27% had dyspnea alone and 24% had dyspnea then chest pain.
Ischemia Raises LV End-Diastolic Pressure
- Exercise-induced ischemia raises left ventricular end-diastolic pressure (LVEDP).
- The Mayo study found LVEDP rose from ~19 to 30 mmHg with exercise in CAD patients.
Stiff Ventricle, Not Extra Volume
- LVEDP rises from reduced LV compliance during ischemia rather than from increased volume.
- Atrial pacing studies showed pressure increased without an increase in end-diastolic volume, implying stiffer myocardium.