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English translation: Pulmonary artery systolic pressure
10:09 Mar 7, 2021
German to English translations [PRO] Medical - Medical: Cardiology / Herzklappen
German term or phrase:sysol. PAP
I am having problems with this sentence as it doesn't seem to make much sense to me. It is from a doctor's report on an inpatient who has all sorts wrong, but this section regards the heart:
Trikuspidalklappe mit leichtgradiger Insuffizienz und einem max. sysol. PAP von 28 mmHG+ ZVD.
I assume "sysol." is an error and should be "systol.", but for PAP I have found various things, but I am not sure whether it is "positive" or "peak" airway pressure, and what I really don't understand it how the central vein pressure comes into it all. If someone could explain?
Thanks to everybody for their help on this one, particularly to Renee for suggesting the answer and to Steffen for being patient with me! Don't know what I would do without you all! 4 KudoZ points were awarded for this answer
... for your explanation, now it makes perfect sense - and so does Steffen's remark that the + should be between the two, not on the 28 mmHg. Sometimes it is difficult to differentiate between source errors and intentional wording/signing. Thanks again to all of you!
Let me sum up the previous contributions (assuming this report is based on echokardiography findings rather than invasive catheterization): Doppler echokardiography does not measure absolute pressures, but only pressure differences across cardiac valves. Here, 28mmHg would be the pressure difference between right atrium and right ventricle. The tricuspid valve is the "border" between the central venous system (ends with right atrium) and the pulmonary arterial system (starts with the right ventricle). Absolute pulmonary arterial pressure (equivalent to right ventricular pressure) would therefore be equal to the (unknown) absolute pressure in the right atrium (or CVD) plus the pressure difference measured at the tricuspid valve. HTH!
ZVP (central venous pressure) and tricuspid valve.
17:03 Mar 7, 2021
ZVD stands for central venous pressure; that is, the pressure in the VENA CAVA. The vena cava is connected to the right atrium; then between the right atrium and the right ventricle is the tricuspid valve. Finally, the pulmonary artery is connected to the right ventricle. Unlike the other arteries, the pulmonary artery carries UNOXYGENATED BLOOD to the lungs. Thus, everything is interconnected, any disorder in the tricuspid valve will affect ZVD (CVP) and pulmonary artery pressure.
... CVP is in the normal range because no separate figure is mentioned in this case. And the plus sign should have been placed directly before "ZVD" (i.e. "28 mmHg +ZVD").
Ah, that makes sense - because the + was closer to the mmHG, I assumed it meant "above" 28 mmHG, but if you say this is fairly common in German reports... Do the two pressures actually add up to something or is it just to say, CVP is normal?
Alternatively, the cardiologist may have assumed a "standard" CVP level, which usually ranges from 2 to 4 mmHg, and "symbolically" added it to the sPAP without measuring it separately. See https://eref.thieme.de/ebooks/1138531#/ebook_1138531_SL47465...
At any rate, the notation "+ZVD" appears to be fairly common in German reports.
Am citing from the linked article, Bettina: ‘It is possible to gain insight into the right and left ventricular preload following the insertion of a central venous catheter and pulmonary artery catheter to measure central venous pressure and pulmonary capillary wedge pressure, respectively. Abnormal measurements can indicate a pathophysiological state and guide management.’
I'm probably rather slow this morning, but I still don't see the connection - as far as I can tell from both of your references, PAP and CVP are two different things, so why are they mentioned here in the same sentence? If 28 mmHG+ is PAP, why mention CVP at all? Is something missing here? I just don't get it.
Thanks, Renee, but what has ZVD got to do with it?
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Answers
6 mins confidence: peer agreement (net): +5
Pulmonary artery systolic pressure
Explanation: Normal pulmonary artery systolic pressure at rest -as measured on Echocardiography -is 25 mmHg
Renee Kulkarni MD India Specializes in field Native speaker of: English PRO pts in category: 32
Grading comment
Thanks to everybody for their help on this one, particularly to Renee for suggesting the answer and to Steffen for being patient with me! Don't know what I would do without you all!
peer agreement (net): +5