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J Thorac Cardiovasc Surg 2005;130:952
© 2005 The American Association for Thoracic Surgery

Letters to the Editor

Reply to the Editor:

Henry L. Waters, III, MD

Chief, Cardiovascular Surgery, Children's Hospital of Michigan, Associate Professor of Surgery, Wayne State University School of Medicine, Detroit, MI 48201

I thank Dr Protopapas for the reminder that the strict definition of gradient is the rate of change of temperature, pressure, or another variable as a function of distance. In cardiovascular medicine we do, however, commonly use the term pressure gradient to describe the difference in pressure between two communicating cardiovascular chambers. Although this latter definition does not conform to the definition of gradient contained in physics textbooks, it is listed without apology in Stedman's Medical Dictionary, just a few lines below the formal physics definition of this term. 1 Go Perhaps primordial physicians selected the term gradient to describe drops in pressure across various types of vascular obstructions because it appeared more descriptive and dramatic than the word difference. Difference falls rather dull and flat upon the human ear. Whatever the reason, pressure gradient, as used in our article, 2 Go is a commonly used medical term that I predict will persist because its particular meaning in cardiovascular medicine is widely accepted and understood. I suggest we acknowledge that by virtue of common usage some terms are used in different contexts to mean different things. Our use of the term pressure gradient in the context of a discussion on pulmonary artery bands was clear and unambiguous.

References

  1. Stedman's medical dictionary. 23rd ed.. Baltimore: Williams & Wilkins; 1976. pp. 599.
  2. Piluiko VV, Poynter JA, Nemeh H, Thomas RL, Forbes TJ, Delius RE, et al. Efficacy of intraluminal pulmonary artery banding. J Thorac Cardiovasc Surg 2005;129:544-550.[Abstract/Free Full Text]

Related Article

Pressure gradient in hemodynamics: Is it measured in units of pressure?
Aristotle D. Protopapas
J. Thorac. Cardiovasc. Surg. 2005 130: 952. [Extract] [Full Text] [PDF]




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Right arrow Congenital - acyanotic
Right arrow Congenital - cyanotic
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