The Atria
摘要
The atria are often overlooked in circulatory failure. Discussions on the right and left atria are often limited to central venous and pulmonary artery wedge pressure measurements. However, the central venous and pulmonary artery wedge pressure waveforms are windows into the right and left heart systems respectively. Understanding the physiology that underpins the changes in filling pressure waveforms could aid the diagnosis and management of patients with circulatory shock. This chapter will discuss (i) the measurement of central venous pressure, (ii) the pressure–volume relationship of the atria and the resultant central venous and pulmonary artery wedge pressure waveforms, (iii) abnormal pressure waveforms and the underlying pathophysiology, and (iii) atrial function, as reservoirs, conduits and pumps for the right and left heart systems. The clinical implications of central venous and pulmonary artery wedge pressure waveforms will also be discussed.