Which of the following pulsed-wave (PW) Doppler spectral patterns would be least likely seen in a patient with chronic constrictive physiology?
A. Tricuspid valve inflow (Fig. A)
B. Mitral valve inflow (Fig. B)
C. LV outflow tract (Fig. C)
D. Descending abdominal aorta (Fig. D)
E. Distal right common carotid artery (Fig. E)
Answer: C. Images A, B, D, and E from the patient with chronic constrictive pericarditis (radiation therapy for lymphoma).Cardiac hemodynamics and their relationship to Doppler patterns in constrictive physiology are depicted in schematic Figure
Image A is a PW Doppler obtained from tricuspid valve inflow from a patient with constrictive pericarditis demonstrating >50% variation in tricuspid valve inflow E-wave with normal respiration. During inspiration, there is increase in the right-sided flow as evidenced by increase in velocity of the tricuspid inflow E-wave.
