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Step I Rapid Squatting
Started by seminoma
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Yea so ti increases Both afterload and preload
Afterload as you know due to increase systemic vascular resistance from constriction of the femoral artery which reverses the shunt to L to R.
Preload becuase the reversal of the shunt to L to R eventually increases LVEDP AND LVEDV which are both parameters of preload.
wouldn't look to much into it tho. I just think knowing that afterload is increased and the method behind it is important.
I think more importantly you should know that Tetralogy of fallot, Truncus arteriosus and Transpostion of the great vessels are all due to failure of neural crest cell migration. They love that ish.
Afterload as you know due to increase systemic vascular resistance from constriction of the femoral artery which reverses the shunt to L to R.
Preload becuase the reversal of the shunt to L to R eventually increases LVEDP AND LVEDV which are both parameters of preload.
wouldn't look to much into it tho. I just think knowing that afterload is increased and the method behind it is important.
I think more importantly you should know that Tetralogy of fallot, Truncus arteriosus and Transpostion of the great vessels are all due to failure of neural crest cell migration. They love that ish.
Squatting rapidly is like a one way ticket to snap city.
Really though, I have no idea what FA is talking about with this either and would love to know if it is a variation of the standard squat (30 sec then rapid stand).
Squatting rapidly is like a one way ticket to snap city.
Really though, I have no idea what FA is talking about with this either and would love to know if it is a variation of the standard squat (30 sec then rapid stand).
It's all about perfect form Bro!
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Thanks. I'm asking regarding how it relates to murmurs.
So "squatting" is like a one time deal? Tell the patient to squat down and, while they're squatting, you listen and MR will get louder but MVP will get softer.
"Rapid squatting" involves the patient quickly doing several squats and then you listen and their AS murmur will get louder?
I understand all the starling stuff etc, but I can't wrap my head around how exactly you do a "rapid squatting" thing at the bedside lol.
Just get an echo.
Maybe they mean to distinguish squatting from rapid squatting by the amount of time you wait to listen to the murmur.
Squatting you wait a bit, afterload is increased .
Rapid squatting you listen quick so the preload as well as afterload is increased.
Rapid squatting compresses leg veins increases venous return thereby increasing preload.
Prolonged squatting (similar to handgrip maneuver) increases SVR thereby increasing afterload.
In Mitral Valve Prolapse, standing decreases venous return causing the heart chambers to become smaller. This makes the mitral leaflet to prolapse into LA earlier and making the murmur (due to MR) more intense and prolonged (as the systolic click moves closer to S 1 ).
With rapid squatting, venous return increases causing the heart chambers to become larger. This makes the mitral leaflet to prolapse later and making the murmur (due to MR) less intense and of shorter duration (as the systolic click moves closer to S 2 ).
In MVP, anything that increases left ventricular chamber size, such as squatting or handgrip, will decrease the murmur.
So, it doesn't matter if it is rapid or prolonged squatting since both will decrease the murmur of MVP.
Looks like in FA 2014 all the arrows for MVP are pointing in wrong direction.
Prolonged squatting (similar to handgrip maneuver) increases SVR thereby increasing afterload.
In Mitral Valve Prolapse, standing decreases venous return causing the heart chambers to become smaller. This makes the mitral leaflet to prolapse into LA earlier and making the murmur (due to MR) more intense and prolonged (as the systolic click moves closer to S 1 ).
With rapid squatting, venous return increases causing the heart chambers to become larger. This makes the mitral leaflet to prolapse later and making the murmur (due to MR) less intense and of shorter duration (as the systolic click moves closer to S 2 ).
In MVP, anything that increases left ventricular chamber size, such as squatting or handgrip, will decrease the murmur.
So, it doesn't matter if it is rapid or prolonged squatting since both will decrease the murmur of MVP.
Looks like in FA 2014 all the arrows for MVP are pointing in wrong direction.
Since this got bumped up, I'll add that I think I figured this out.. or at least a way to think about it.
"Rapid" squat = what happens when you suddenly go from standing to squatting (i.e. preload increases).
"Squat" = a more subacute/chronic change (increase afterload).
"Rapid" squat = what happens when you suddenly go from standing to squatting (i.e. preload increases).
"Squat" = a more subacute/chronic change (increase afterload).
