Document Detail

A new angle on the Angle of Louis.
MedLine Citation:
PMID:  16894277     Owner:  NLM     Status:  MEDLINE    
Previous literature has stated that the center of the right atrium lies approximately 5 cm below the sternal angle regardless of body position. Our objective was to measure the distance from the Angle of Louis to various locations in the right atrium and determine whether these distances vary with patients' body habitus. The authors conducted a cross-sectional study with 52 consecutive patients who underwent computed tomography. The Angle of Louis was measured to various right atrial anatomic locations and was correlated with patients' body habitus characteristics. There was a positive correlation between patients' weight or body mass index and the distance of the Angle of Louis to right atrial locations. Therefore, using the traditional 5 cm in an obese patient can and usually will result in an underestimation of right atrial pressure. The authors suggest that in patients with body mass index > 35 kg/m2 (body surface area > 2.5 m2), a jugular venous column height at the clavicle is likely to indicate significantly elevated jugular venous pressure and should be considered abnormal. Therefore, further clinical assessment and subsequent therapeutic decisions of these morbidly obese patients with abnormal jugular venous pressures should be made accordingly.
Ravi K Ramana; Thriveni Sanagala; Robert Lichtenberg
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Congestive heart failure (Greenwich, Conn.)     Volume:  12     ISSN:  1527-5299     ISO Abbreviation:  Congest Heart Fail     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-08-08     Completed Date:  2006-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9714174     Medline TA:  Congest Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  196-9     Citation Subset:  IM    
Division of Cardiology, Loyola University Medical Center, Maywood, IL 60153, USA.
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MeSH Terms
Aged, 80 and over
Atrial Function, Right*
Body Height*
Body Mass Index
Body Weight*
Central Venous Pressure*
Heart Atria / anatomy & histology*
Jugular Veins / anatomy & histology
Middle Aged
Obesity, Morbid / physiopathology*
Point-of-Care Systems
Supine Position
Vena Cava, Superior / anatomy & histology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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