A 55 year old man with left AV valve insufficiency is seen in the emergency room

Question

A 55 year old man with left AV valve insufficiency is seen in the emergency room. On examination he is found to have a loud and prolonged first heart sound accompanied by gurgling sounds. In addition, exam indicates significant pulmonary edema (congestion).

Blood pressure = 90/50                      (normal 120/80 mmHg)

Heart Rate = 110 beats/min                (normal 70 beats/min)

CO = 3.2 L/min                                  (normal 5L/min)

MAP = 80 mmHg                               (normal 93 mmHg)

Left atrial pressure = 22 mmHg          (normal < 7-8 mmHg)

Right ventricular pressure = 50/10 mmHg      (normal is 24/2-4 mmHg)

Arterial PO2 = 75 mmHg                     (normal = 100 mmHg)

Cyanosis of extremities and lips (bluish coloring of fingers/toes/lips)

1.(a) What are the two factors that determine cardiac output? (b) Explain why this patient

Explanation / Answer

1. Cardiac output (known as

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