Page 550 - Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice

538 FLUID THERAPY

I

Ao
150- Ao –100 –100
Ao
100- –100
50-
0-
–40
45-
PA 30- –30 PA –30

15-
RV –0
0- –0

RA –30
RA RA –5
–10 –15 –0
A B C
Figure 21-8 A, Electrocardiogram and pressure recordings from a standing dog with dilated
cardiomyopathy and biventricular cardiac dysfunction. There is pulmonary hypertension secondary to
abnormally high wedge pressure (not shown) and left-sided cardiac dysfunction. The pulmonary artery
pressures are approximately 39/23 (systolic/diastolic) mm Hg. The right atrial pressure (central venous
pressure) is also abnormally high, with a mean value of approximately 9 mm Hg. Scales indicate millimeters of
mercury for the adjacent curves. Ao, Pressure in the descending aorta; PA, pressure in the pulmonary artery;
RA, pressure in the right atrium. B, Electrocardiograph (ECG) and pressure recordings from a standing dog
with dilated cardiomyopathy and mitral and tricuspid regurgitation during infusion of 0.9% saline solution.
Volume expansion has led to a marked increase in the right atrial pressure (mean, 16 mm Hg). The right
ventricular pressure (RV) tracing also indicates an increase in the end-diastolic ventricular pressure (arrow).
Pulmonary hypertension from left-sided heart failure accounts for the increase in systolic RV pressure
(42 mm Hg, normal is <25 mm Hg). Scales on the right indicate millimeters of mercury for the preceding
curves. C, ECG and pressure recordings from a standing dog with mitral regurgitation and mild left-sided
heart failure. Pulmonary hypertension secondary to abnormally high wedge pressure (not shown) and left-
sided cardiac dysfunction are present. The pulmonary artery pressures are approximately 34/25 (systolic/
diastolic) mm Hg. The wedge pressure in this case was approximately 23 mm Hg. Despite the high left-sided
filling pressures, note that right atrial pressure is normal, with a mean (central venous pressure) value of
approximately 3 mm Hg. Scales on the right indicate millimeters of mercury for the preceding curves.

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