Modifying Effects of Interatrial Septal Defect on the Cardiodynamics of Mitral Stenosis

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Abstract
Mitral stenosis was produced acutely in dogs (a) without an interatrial septal defect, and (b) in the same dog after the production of a defect. Without the defect mitral stenosis resulted in a decrease of systolic and diastolic aortic pressure, marked increase of left atrial pressure, and little change of right atrial pressure. The aortic pressure pulse showed a characteristic change of contour. The upstroke became steeper and the pressure declined rapidly during the last half of systole, resulting in a peaked curve. The max. increase of left atrial pressure occurred at the V point. Systolic left ventricular regurgitation occurred in most expts. In the presence of an interatrial septal defect mitral stenosis resulted in the same changes of contour and pressure of the aortic curve. Left atrial pressure increased markedly, in some instances to a greater extent than before the defect, although the degree of stenosis was the same. Right atrial pressure increased only slightly. It is concluded that in the acute expt. the superimposition of an interatrial septal defect on mitral stenosis is without detectable dynamic effect.

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