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Pulmonary vein Doppler flow in a patient with fatigue and dyspnoea
  1. Jasneet Kaur Devgun,
  2. Tharwat Nasser,
  3. James Lee
  1. Division of Cardiology, Henry Ford Heart and Vascular Institute, Detroit, Michigan, USA
  1. Correspondence to Dr James Lee, Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI 48202, USA; jlee24{at}hfhs.org

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Clinical introduction

A woman in her 80s with a medical history of uncontrolled hypertension, hyperlipidaemia and diet-controlled pre-diabetes presented to a primary care physician’s office with fatigue and dyspnoea on exertion of 2–3 months’ duration. The patient reported no chest pain, paroxysmal dyspnoea or orthopnoea. Medications included atenolol 50 mg once a day. Blood pressure in the clinic was 158/75 mm Hg. An echocardiogram was performed.

Question

Which of the following explains the pulmonary vein pulsed wave Doppler flow signal, as shown in figure 1?

Figure 1

Pulsed wave Doppler of the pulmonary vein on transthoracic echocardiogram.

  1. Blunting of systolic flow due to severe mitral regurgitation

  2. Atrioventricular conduction block

  3. Normal Doppler …

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Footnotes

  • Twitter @JasneetDevgun

  • Contributors All authors have contributed significantly to the conception, design, writing and review of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.