* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Chronic valvular disease
Cardiovascular disease wikipedia , lookup
Management of acute coronary syndrome wikipedia , lookup
Cardiac contractility modulation wikipedia , lookup
Electrocardiography wikipedia , lookup
Heart failure wikipedia , lookup
Pericardial heart valves wikipedia , lookup
Coronary artery disease wikipedia , lookup
Quantium Medical Cardiac Output wikipedia , lookup
Rheumatic fever wikipedia , lookup
Cardiac surgery wikipedia , lookup
Myocardial infarction wikipedia , lookup
Jatene procedure wikipedia , lookup
Artificial heart valve wikipedia , lookup
Dextro-Transposition of the great arteries wikipedia , lookup
Lutembacher's syndrome wikipedia , lookup
Hypertrophic cardiomyopathy wikipedia , lookup
Arrhythmogenic right ventricular dysplasia wikipedia , lookup
Chronic valvular disease The valves are involved by some kinds of diseases or the inborn developmental anomaly of valves. Common causes:Rheumatic heart disease(RHD) Infective endocarditis Artherosclerosis(AS) Diseased region: bicuspid valve (mitral valve ) 、 aortic valve Main changes: Two types:valvular stenosis valvular insufficiency Function of normal valve pulmonary circulation left atrium aortic valve pulmonary valve bicuspid valve right atrium tricuspid valve right ventricle left ventricle Stenosis and insufficiency Valvular stenosis Stenosis is the failure of a valve to open completely. Reason:valve leaflet change to hard or have lower elasticcity because of more scar tissue or calcification Result:less blood flow into the next cavity of heart during diastole Valvular insufficiency Valvular insufficiency is the failure of a valve to close completely. Reason:the area of valve change to small or the valve leaflet change to long. Result:back flow or regurgitation of the blood during systole. Mitral stenosis Reason:RHD、SBE。 Valve change to thick、hard,lower elasticity Fish-mouse Haemodynamics changes mitral stenosis——compensatory hypertrophy of left atrium——congestion of lung——pulmonary artery hypertension——congestion of right ventricle——right heart insufficiency—— congestion of systemic circulation Clinical features: The features of congestion of lung and congestion of systemic circulation: •Anhelation, cyanosis, pink frothy sputum, mitral facies. •Hepatomegaly, splenomegaly, •Edema of lower extremity mitral facies hypoxia Imageology The volume of left atrium and right ventricle increased The shape like a pear (pear-shaped heart ) Mitral incompetence(MI) MI——compensatory hypertrophy of left atrium——compensatory hypertrophy of left ventricle—— congestion of lung——pulmonary artery hypertension——right heart insufficiency——congestion of systemic circulation Clinical features are same to mitral stenosis The volume of left atrium and left ventricle increased (Spherical heart) Aortic stenosis Normal aortic valve aortic stenosis Aortic stenosis Aortic stenosis—cardiac output of left ventricle decreased --left ventricular hypertrophy→left ventricle dilatation Clinical features:angina, pulse pressure decreased, congestion of lung The shape of heart likes a boot (boot-shaped heart ) Aortic incompetence Aortic incompetence---back flow of the blood—left ventricular hypertrophy—— congestion of lung — pulmonary artery hypertension—congestive heart failure— —congestion of systemic circulation Clinical cure Cardiac valve operation: Repair or displace one or more valves. Cardiomyopathy It is means disease of the heart muscle but the term was originally coined to restrict its usage to myocardial disease of unkown cause. Cardiomyopathy are classified into two broad groups: 1.Primary Cardiomyopathy 2.Secondary Cardiomyopathy Primary Cardiomyopathy : This is a group of myocardial disease of unkown cause. Secondary Cardiomyopathy : This is a group of myocardial disease of known etiologies or having clinical associations. Primary Cardiomyopathy It is an independence disease of unkown cause.It has nothing to do with hypertension, coronary artery disease and RHD. The main changes include hypertrophy of cadiocyte and hyperplasy of fibrous tissue.It is not an inflammatory disease. Three types: 1、Dilated(congestive) cardiomyopathy 2、Hypertrophic cardiomyopathy 3、Restrictive cardiomyopathy Dilated cardiomyopathy End-results of various agnogenic cardiomyopathies Most common type(90%) Male >Female,age of onset :20-50age Main futures: •Highly expand of the cavity of heart •Cardiac failure Etiology •Viral infection •Excessive drinking •Pregnancy •Heredity •Dysbolism •Intoxation Pathological change Gross appearance: •Volume increased,weight increased (400750g)。 •Ventricular hypertrophy,all cavities expand, the thickness of cardiac apex decreased •The thickness of endocardium increased The shape of heart likes a ball Left ventricle dilatation,the cavity expand Light microscope : •Hypertrophy and elongate of Part of cadiocytes. •Interstitial fibrosis of endocardium and cardiac muscle •Sometimes,we can find degeneration of cadiocyte Hypertrophic cardiomyopathy Gross appearance: •Conspicuous hypertrophy of all ventricles, cardiac weight increased(double weight) •The thickness of left ventricular wall increased, cardiac stenosis. •Endocardium under the atrioventricular valve and aortic valve is thickening. Light microscope : •Hypertrophy of Widespread cadiocyte. •Cadiocytes arrange chaotic. •Some fibrosis and scar tissue. Cadiocytes arrange chaotic Restrictive cardiomyopathy Gross appearance : Endocardial fibrosis of ventricles,the endocardium is thickening about 2~3mm, grey or white. Endocardial thickening Light microscope : •Fibrosis and hyalinization of endocardium •Atrophy and degeneration of cardiac muscle Distinguishing features of the three types DCM HCM Restrictive cardiomyopathy Big cavity Thin wall Small cavity Thick wall Cardiostenosis Hypertrophy Widespread and hypertrophy and degeneration of degeneration part cadiocytes Interstitial fibrosis and scar tissue Fibrosis and hyalinization of endocardium Nomenclature definition 1.Foam cell 2.CHD 3.subendocardial infarction 4.transmural myocardial infarction 5. Primary granular contracted kidney 6. Hypertensive encephalopathy 7. Aschoff Body 8. Anitschkow cell 9. trichocardia 10. Spherical heart 11. pear-shaped heart 12. boot-shaped heart Questions 1.Pathologic change of AS 2. Pathologic change of benign hypertension 3. Basic pathological changes of RF 4. Difference between RF and SIE 5. Difference among the three types of cardiomyopathy