Restrictive/constrictive physiology is characterized by decreased ventricular compliance or pericardial constraint, with an associated rise in ventricular filling pressures. It can result from constrictive pericarditis, restrictive cardiomyopathy, andany condition that results in rapid dilation of one or both ventricles.' The classic constrictive physiologic findings on invasive pressure measurements during cardiac catheterization include: a steep y descent with an abrupt rise and plateau after early diastolic filling in all 4 chambers, elevated atrial pressures during atrial contraction and ventricular systole, large atrial reversal waves with reduced S and D waves on pulmonary venous flows, high filling pressures of both ventricles and atria, and diastolic pressure equilibration of all four chambers.' All of these characteristics can also be associated with restrictive cardiomyopathy.
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