“Auricularization” of right ventricular pressure curve

Abstract

Two cases are presented which show particular hemodynamic patterns, characterized by the recording of an auricular pressure curve from the right ventricle and the main pulmonary artery. Anatomic study proved the clear distinction between the two subjects. In the first patient, the biopsy of the right auricular appendage, performed during the cardiac operation, showed a diffuse endocardial fibroelastosis; in the second patient, at autopsy a massive fibrosis of the right ventricle, dependent upon an infarction of the right ventricle, was observed. Evidence is presented to support the view that the pulmonary blood flow was maintained by the contraction of the right atrium, which was greatly hypertrophied, whereas the right ventricle acted merely as a passive stiff chamber. The right heart insufficiency appeared when the right atrium failed to support the pulmonary circulation; the congestive failure coincided with the failure of the right atrium. From the study of these cases, the nonessentiality of the right ventricle in the pump mechanism of the heart previously observed in the experimental field seems to be demonstrated also in human beings.