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Parasternal Long Axis (PSAX) View
Presentation
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Complications
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Diastolic Physiology
What is diastole?
Diastole is the interval from aortic valve closure (end-systole) to mitral valve closure (end-diastole)
What are the phases of diastole?
Can be divided into four phases:
Isovolumic relaxation
Early rapid diastolic filling
Diastasis
Late diastolic filling
(caused by atrial contraction)
- Starts with aortic valve closure, followed by a rapid decline in LV pressure.
- When LV pressure falls below LA pressure, the mitral valve opens, ending the isovolumic relaxation period.
- Mitral valve opening is followed by rapid early diastolic filling.
- The rate and time course of LA to LV flow is determined by several factors including:
- The pressure difference along the flow stream
- Ventricular relaxation
- The relative compliances of the two chambers
- As the ventricle fills, pressures in the atrium and ventricle equalize, resulting in a period of diastasis.
- During this time little movement of blood between the chambers occurs, and the mitral leaflets remain in a semi open position.
- The duration of diastasis depends on heart rate:
- Longer at slow heart rates
- Entirely absent at faster heart rates.
- With atrial contraction, LA pressure again exceeds LV pressure.
- Results in further mitral leaflet opening and a second pulse of LV filling.
- In normal individuals this atrial contribution accounts for only about 20% of total ventricular filling.
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Work-Up Summary
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