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Cardiac Pathology and Diagnosis Unit 4 Cardiorespiratory Med Terminology Congestive Heart Failure Reduction in the effective contractile force of the LV, which results in a decreased amount of blood due to a weakness in the myocardium. The signs and symptoms which students usually present with are weakness, breathlessness, and edema. Diagnostic Tests may include (but are not limited to) (1) echocardiography; (2) cardiac catherterization; (3) electrocardiography; and (4) stress testing (treadmill). Atherosclerosis (of the aorta in photo) This is the most common form of arteriosclerosis. This pathology is caused by the deposition of fatty yellowish plaques of cholesterol on the inner walls of the arteries. This photo features the plaque buildup on the walls of the aorta. Diagnosis may be performed by cardiac catheterization (cath lab) by an invasive cardiologist or intervention radiologist. Angiography may also aid in the diagnosis of atherosclerosis. Atherosclerosis The damage from atherosclerosis comes in two main stages: 1. As plaque deposits and builds on the walls of the arteries. Platlets and fibrin deposit on the outside of a plaquemaking the lumen of a vessel very narrow. 2. A thrombus forms in the very narrow space of the lumeneventually causing a complete blockage. Myocardial Infarction Partial or complete occlusion or obstruction of one or more of the vessels of the coronary circulation. Patients refer a strong squeezing pain or heavy pressure in the middle of the chest (angina pectoris). This photo shows the infiltration of neutrophils due to the destruction of myocardium-because of its rapid onset-this condition would be further classified as an acute MI. Myocardial Infarction • A myocardial infarction may be identified clinically by several of the following tests: • (1) Cardiac enzymes; (2) Serum lippoprotein level; (3) Cardiac scan; (4) Electrocardiograph. Coronary artery disease Insufficient blood supply to the myocardium due to an obstruction of one or multiple coronary vessels. This condition may start from atherosclerosis and may progress to a myocardial infarction. Diagnostic procedures which could be used to help in the diagnosis of this condition would include; (1) Doppler ultrasonography; (2) echocardiography; and cardiac catherization; and (3) electrocardiography. Arrthymia and Fibrillation Arrhythmia- Any irregular heartbeat or action. There are many different forms of this and a rang of severities which this may present as. EKG is a traditional means of confirming this condition. Fibrillation is a severe form of an arrhythmia resulting in a complete dissociation of electrical impulse conduction between the atria and ventricles-the ventricle are ineffective in ejecting sufficient blood out due to chaotic, asynchronous contractile activity. Pericarditis Pericarditis is characterized by a fibrinous inflamation of the two-layer pericardial sac which surrounds the heart. Myocarditis is the inflamation of the muscle layer of the heart. Confirmation of this condition can be done by biopsy and microscopic examination by a pathologist. Tetrology of Fallot • Congenital defect of the heart which consists of the following abnomalities: • (1) Ventricular septal defect- an opening in the ventricular septum seperating the R and L ventricles. • (2) Pulmonary obstruction-RV outflow obstruction. This results in right ventricular hypertrophy. • (3) An overiding aorta-the aorta id dhifted to the right so that it lies over the ventricular septal defect. • As the text points out this requires immediate surgey to correct this condition.