Abstract
A 73-YEAR-OLD WOMAN suffered a cardiac arrest in the emergency department waiting room. After prompt resuscitation and admission to the coronary care unit, coronary angiography showed critical stenosis of the left main and left circumflex arteries. An intra-aortic balloon pump was placed, a heparin infusion was initiated, and the patient was brought for urgent coronary artery bypass grafting. Transesophageal echocardiography revealed the unexpected finding of near-systemic right ventricular systolic pressure by tricuspid regurgitation jet velocity on continuous wave Doppler. Midesophageal 4-chamber (Fig 1), midesophageal right ventricular inflowoutflow, and transgastric right ventricular inflow (Fig 2) views revealed a moderate tricuspid regurgitation jet with maximum velocity of 4.88 m/sec, which predicts a right ventricular
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