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Volume 156, Issue 6 , Pages 1222.e1-1222.e7 , December 2008

Direction of blood flow from the left ventricle during cardiopulmonary resuscitation in humans—its implications for mechanism of blood flow

Hyun Kim, MD
- Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Sung Oh Hwang, MD
- Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
- Reprint requests: Sung Oh Hwang, MD, Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, 162 Ilsandong, Wonju 220-701, South Korea.
Christopher C. Lee, MD
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
Kang Hyun Lee, MD
- Department of Emergency Medicine, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Jang Young Kim, MD
- Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Byung Su Yoo, MD
- Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Seung Hwan Lee, MD
- Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Jung Han Yoon, MD
- Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Kyung Hoon Choe, MD
- Department of Cardiology, Institute of Lifelong Health, Wonju College of Medicine, Yonsei University, Wonju, South Korea
Adam J. Singer, MD
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY

Received 3 April 2008 ,Accepted 8 September 2008.

Direction of blood flow on left ventricular contrast echocardiography with 135° longitudinal view. Before (A) injection of contrast, the mitral valve remains open and aortic valve is closed during com

Direction of blood flow on left ventricular contrast echocardiography with 135° longitudinal view. Before (A) injection of contrast, the mitral valve remains open and aortic valve is closed during compression diastole. Contrast begins to inject into the left ventricle at initiation of compression systole (B). At the end of compression systole, the image of the left ventricle is obscured due to sudden compression and opacification of the ventricular cavity by contrast, and retrograde flow (arrow) into the left atrium through the mitral valve was seen. During relaxation period, the contrast is seen in the left atrium (D and E). After 2 successive compression, the contrast remains in the left atrium, the left ventricle, and the aorta (F).
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