![]() ![]() The other peak, the A wave, is the left atrial pressure wave that follows active atrial contraction. The V waves are passive atrial filling waves and occur during ventricular systole. Flow from the pulmonary veins into the left atrium is pulsatile, and the classical pressure wave form exhibits a V wave and an A wave. Around 12–25% of the population have either the two right, or the two left pulmonary veins entering through a single ostia. Left atrial physiologyĪlthough the classical anatomy is that of four pulmonary veins, two superior and two inferior, draining separately into the left atrium (LA), this is only the case in 70% of individuals. Accurate manipulation of cardiopulmonary performance using the limited tools available demands a more in-depth understanding of LA physiology and pressure measurement. Raised LAP may be due to pre-existing left ventricular systolic and/or diastolic dysfunction, mitral and/or aortic valve pathology however, acute increases in LAP can be seen in critical illnesses such as sepsis, myocardial ischemia, stress-induced cardiomyopathies and volume overload states. Increases in LAP have important consequences for gas exchange, pulmonary haemodynamic load and right ventricular performance. However, the left atrium is a key component of the ‘transpulmonary circuit’ with upstream and downstream functions as reservoir, conduit and pump. A clinician’s interest in the left atrial pressure (LAP) usually pivots around its preload contribution to cardiac output. ![]()
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