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(Chest. 1973;64:540-542.)
© 1973 American College of Chest Physicians

Misdiagnosis of Valvular Aortic Stenosis in Isorhythmic Dissociation

Michael L. Hinnen M.D.1; E. Louise Kremkau M.D.1; and Shahbudin H. Rahimtoola M.B., F.C.C.P.1

1 Division of Cardiology, Department of Medicine, University of Oregon Medical School, Portland

Failure to recognize isorhythmic dissociation and to record simultaneous ventricular and arterial pressure during cardiac catheterization led to the erroneous diagnosis of aortic stenosis in a 70-year-old man. The atrioventricular conduction disturbance and absence of an aortic systolic gradient were documented at a subsequent catheterization. During isorhythmic dissociation, PR interval changes resulted in phasic variation of left ventricular end-diastolic pressure and, therefore, of left ventricular and arterial systolic pressure.






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Copyright © 1973 by the American College of Chest Physicians.