Clinical assessment of heart chamber size and valve motion during cardiopulmonary resuscitation by two-dimensional echocardiography

Stuart Rich, Hershel L. Wix, Edward P. Shapiro

Research output: Contribution to journalArticle

Abstract

It has been generally accepted that enhanced blood flow during closed-chest CPR is generated from compression of the heart between the sternum and the spine. To visualize the heart during closed-chest massage, we performed two-dimensional echocardiography (2DE) during resuscitation efforts in four patients who had cardiac arrest. 2DE analysis showed that (1) the LV internal dimensions did not change appreciably with chest compression; (2) the mitral and aortic valves were open simultaneously during the compression phase; (3) blood flow into the right heart, as evidenced by saline bubble contrast, occurred during the relaxation phase; and (4) compression of the right ventricle and LA occurred in varying amounts in all patients. We conclude that stroke volume from the heart during CPR does not result from compression of the LV. Rather, CPR-induced improved cardiocirculatory dynamics appear to be principally the result of changes in intrathoracic pressure created by sternal compression.

Original languageEnglish (US)
Pages (from-to)368-373
Number of pages6
JournalAmerican heart journal
Volume102
Issue number3 PART 1
DOIs
StatePublished - Sep 1981
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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