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==Inflow obstruction== | ==Inflow obstruction== | ||
At pericarditis or tamponade, there is an obstacle for intake from the atria to the ventricles. Due to the obstruction from outside, eg by pericardial fluid, | At pericarditis or tamponade, there is an obstacle for intake from the atria to the ventricles. Due to the obstruction from outside, eg by the pericardial fluid, the space in the heart becomes restricted and the filling of one ventricle becomes detrimental to the area of the other ventricle. When inhaling the filling of the right ventricle does at the expense of the filling of the left ventricle. This is called interdependence. During tamponade, the outside pressure causing this effect is much more to the ground compared with constrictive pericarditis when the early diastolic filling is not obstructed. This is also always why a tamponade throughout the diastolic filling is almost the reason Pulsus paradoxus is found only rarely in a constrictive. | ||
Inhalation decreases intrathoracic pressure | Inhalation decreases the intrathoracic pressure and thus the pressure longveneuse will also decrease, however the intrapericardially situated diastolic LV pressure will not fall. In other words, by inhalation, reduction in the pressure gradient between the pulmonary veins and left ventricle which result in the filling up of the left ventricle. | ||
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