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🧵Complex #Hemodynamics in ESRD:

Middle age pt ➡️ 🏥 for syncope

HPI: Low BP during HD sessions. Does not achieve dry weight. Today she has had 6 episodes of syncope!

Last episode happened as she stood up from a chair

BP 88/62, HR 87 🧠 OK, CRT 2 sec

1/8
On #Echofist you notice this👇

During systole, flow from the LV towards the Aorta should all be blue in color! (Direction away from the probe)

This apparent change in direction (red sphere) is called Aliasing

Aliasing = Very high flow Velocity!

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Velocity can be quantified!

Use CW Doppler passing through the red sphere 👇

Velocity = 3.8 m/s 🚨🚨🚨 This is very fast!

Whenever you see a very fast flow, think of obstruction (similar to blocking a hose with your thumb👇)

What is causing the obstruction?

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