The effects of nitroglycerin on systemic vascular resistance and cardiac output are highly debated. This study demonstrates that these effects depend on the initial haemodynamic condition, and explains the conflicting results previously reported. 31 patients presenting initially with a fairly wide spectrum of various haemodynamic parameters underwent cardiac catheterisation with measures of parameters before and after nitroglycerin infusion. Multifactorial statistical analysis by correspondence analysis identifies 3 types of haemodynamic responses and demonstrates the association of each response with a particular haemodynamic profile. It is demonstrated that systemic vascular resistance is decreased only when it is initially elevated and cardiac output is increased only when initial pulmonary wedge pressure and systemic vascular resistance are elevated and cardiac output is low. The effects of nitroglycerin on cardiac output, systemic vascular resistance, heart rate and arterial pressure differ significantly according to the presence or not of cardiac insufficiency and depend mainly on the initial value of three parameters: systemic vascular resistance, pulmonary wedge pressure and cardiac output.
Report of a case of obstructive dysfunction of a tricuspid Starr-Edwards (6120) ball prosthesis, diagnosed on phonocardiographic (PCG) diastolic anomalies with abnormal diastolic pattern of the jugular pulse, abnormal jugular flow velocity curve, and confirmed by cinefluoroscopy. The thrombotic origin of the obstruction was assessed on the regression of PCG and cinefluoroscopic anomalies under fibrinolytic therapy.
