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  • Gradient measurements

    I have a gradient of "70" what does that mean?

  • #2
    Sandy,

    Your gradient is a measurement of pressure that indicates the amount of obstruction present through the Left Ventricular Outflow Tract (LVOT) caused by your thickened septum. It is measured in mmHg (or millimeters of mercury, just like a barometer).

    Think of it like placing your thumb over the end of a garden hose. The greater the obstruction at the end of the hose, the higher the water pressure is that builds up behind it, and the faster the water squirts out of the hose. The speed at which the water shoots out of the hose is equivalent to the heart's LVOT velocity (or Left Ventricular Outflow Tract velocity)... the pressure building up behind your thumb reflects your gradient (the difference in pressures on either side of the obstruction). Thus, the two measurements are related to each other. The higher the LVOT velocity, the higher the pressure gradient.

    A gradient of over 30 mmHg has been shown to lead to increased symptoms and poor long-term prognosis because of the extra burden these high pressures place on the heart mechanisms (such as the mitral valve). Thus, medication therapy and/or septal reduction to relieve the obstruction is warranted.

    Hope this helps to answer your question,

    Jim
    "Some days you're the dog... some days you're the hydrant."

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    • #3
      Well said Professor!!
      Dx @ 47 with HOCM & HF:11/00
      Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
      Lead failure,replaced 12/06.
      SF lead recall:07,extracted leads and new device 2012
      [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
      Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
      Genetic mutation 4/09, mother(d), brother, son, gene+
      Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin

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      • #4
        Oh my dear Pam...

        If you only knew what diabolical plans i originally had planned for this thread. LoL. My post was edited quite a number of times before i eventually got it right.

        I had originally gone into a discussion about climatology, and how atmospheric pressure gradients can be likened to the pressures inside the heart... how air molecules travel from high pressure areas (warm fronts) to low pressure areas (cold fronts) which is where wind comes from... therefore the steeper the pressure gradient is between fronts, the stronger the winds are that precede them. I was somehow going to compare this all to LVOT velocity and gradients within the heart, but then abandoned the idea entirely when it just didn't work out quite right.

        Yes i'm a huge nerd, but i can't help myself... i took a Climatology class last term.

        The point i was trying to make with all this (and yes there really was one), is that it's a common misconception that your gradient refers to a specific pressure within the left ventricle. This is untrue. The term 'gradient' by definition refers to the difference in pressures between two points, in this case the upper and lower chambers of the heart, specifically the left atrium and the left ventricle. This creates a high pressure area on one side of the mitral valve, and a low pressure area on the other, which pushes and pulls on the mitral valve in an abnormal way, producing such things as systolic anterior motion of the mitral valve (SAM), mitral valve regurgitation, and the lot.

        Streams have gradients, the atmosphere has a gradient, highways have a gradient... and in each case, it is the steepness of the gradient that has an impact on the flow of molecules between two points along it's path, and not necessarily the specific value at a certain location.

        My God, Burton... what have you done to me???

        Jim
        "Some days you're the dog... some days you're the hydrant."

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        • #5
          Well Jim,
          You can’t say I stupided you up any.

          You have just got to be at least a year post myectomy. Your brain is running at the top of its form – so to speak.

          I’m real proud to know you, my friend, Real proud.
          Burt

          By the way, what the heck are you talking about?

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          • #6
            Jim,

            Are you going to be our next metorologist. I can just see you in a rainbow tie saying "darlin' its gonna be a scorcher today" . And will you add the happy dance to each forcast?

            By the way were where you tonight. For once I had good news to tell you and you bail on me. Your not seeing some one else are you. I'd hate to have to break up before the annual meeting.

            Mary S.

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            • #7
              Gradient

              Hi Sandy, With the gradient of "70" what symptoms are you experiencing..? (Hopefully not that many... )

              Cheers

              Vinnie

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