Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Cardiacpathology 150308162825-conversion-gate01

cardiac abnormalities

Related Books

Free with a 30 day trial from Scribd

See all
  • Login to see the comments

Cardiacpathology 150308162825-conversion-gate01

  1. 1. CARDIAC PATHOLOGY • By- Dr. Armaan SinghBy- Dr. Armaan Singh
  2. 2. PATHOLOGY OF THE HEART • All problems are eventually expressed as inadequate cardiac output. • Leaks in the system • Electrical Conduction, irregular rhythm • Obstruction to flow • Valve problems, obstruction or incompetence • Cardiac muscle weakness and failure
  3. 3. CONGENITAL HEART DISEASE • Clinical symptoms come from mixing blood. • Right (unoxygenated) blood is shunted to… • Systemic output • Cyanosis, either immediate or late • Present at birth • Genetic factors are rare • Environmental (developmental) are common • Maternal infections • Fetal alcohol syndrome
  4. 4. CONGENITAL HEART DISEASE
  5. 5. CONGENITAL HEART DISEASE • Cyanotic heart disease • Child is cyanotic (blue) right from the get go. • Right-sided blood is mixing with systemic. • Non-oxygenated blood (venous blood) is coming directly out in the aorta.
  6. 6. CONGENITAL HEART DISEASE • Tardive cyanotic heart disease. • Tardive means late, late developing. • Comes several years after birth. • Underlying problem has been there all along. • Left to right shunt. • More blood in the pulmonary circulation can handle. • In time the shunt reverses.
  7. 7. CONGENITAL HEART DISEASE • Atrial septal defect • Common and may cause severe shunting. • Several varieties. • Paradoxical embolization.
  8. 8. REPAIR OF AN ATRIAL SEPTAL DEFECT
  9. 9. VENTRICULAR SEPTAL DEFECT • Left to right shunt • Depending on size will lead to Eisenminger reaction. • Later becomes right to left shunt. • Possible infections.
  10. 10. VENTRICULAR SEPTAL DEFECT
  11. 11. VENTRICULAR SEPTAL DEFECT • Colorized Doppler • Note jet at top of frame. • Infection on downstream side. • Eisenminger?
  12. 12. TETRALOGY OF FALLOT • Four problems • 3 defects • 1 compensatory • VSD • Narrowed pulmonary outflow tract • Over-riding aorta • RV hypertrophy
  13. 13. COARCTATION OF AORTA
  14. 14. HEART FAILURE • Diminished out volume of either ventricle. • Systolic failure • Loss of pumping strength. • Backup of blood behind weakened ventricle. • Atherosclerosis leading to chronic ischemia. • Diastolic failure • Reduced ability of ventricle to fill. • Constriction of trapping of ventricle
  15. 15. CONGESTIVE HEART FAILURE • Diminished of pumping ability of left ventricle. • Back up of blood in pulmonary vasculature. • Pulmonary edema • Peripheral edema
  16. 16. BACK PRESSURE
  17. 17. CHF AND EDEMA FORMATION
  18. 18. PULMONARY EDEMA
  19. 19. LIVER CHRONIC PASSIVE CONGESTION
  20. 20. PITTING EDEMA
  21. 21. ISCHEMIC HEART DISEASE • This is the biggie in the western world. • Atherosclerosis of coronary arteries. • Acute vs. chronic ischemia. • Four basic patterns • Angina pectoris • Myocardial infarction • Chronic ischemia leading to CHF • Sudden death from arrhythmia
  22. 22. CORONARY ATHEROSCLEROSIS
  23. 23. CORONARY ATHEROSCLEROSIS • Focal narrowing
  24. 24. MYOCARDIAL INFARCTION
  25. 25. MYOCARDIAL INFARCTION
  26. 26. MYOCARDIAL INFARCTION
  27. 27. MYOCARDIAL INFARCTION • Complications of MI • Cardiogenic heart failure • Sudden loss of pumping strength. • Arrhythmias • Irritable conduction system. • Valvular dysfunction • involvement of papillary muscle • Rupture and tamponade
  28. 28. HYPERTENSION • Many causes • Essential (majority) • No known cause • Stress perhaps • Modifiable causes • Endocrine tumors • Aldosterone • Cushing's Syndrome • Vascular related • Narrowing of renal a. • Primary Renal disease • Excess renin production
  29. 29. CARDIOVASCULAR CHANGES WITH HYPERTENSION • Left ventricular hypertrophy • Abnormal orientation of hypertrophied cells. • Heart failure in time • Arrhythmias • Severe atherosclerosis • Renal disease • Stroke • Aortic wall dissection
  30. 30. LEFT VENTRICULAR HYPERTROPHY
  31. 31. COR PULMONALE • Right-sided failure secondary to intrinsic pulmonary disease. • Emphysema • Scaring conditions of the lung • Chronic embolization
  32. 32. VALVULAR DISEASE • Stenosis (won’t open all the way) • Incompetent (won’t close all the way) • Embolization of junk from a valve
  33. 33. RHEUMATIC FEVER • Streptococcal infection starts it. • Antibodies are made against Strep wall. • Antibodies cross react with connective tissue. • Type II hypersensitivity. • Many systems become involved.
  34. 34. RHEUMATIC FEVER • Antibodies cross react with connective tissue. • Joint symptoms • Skin • Heart • CNS
  35. 35. RHEUMATIC CARDITIS • All parts of the heart are involved. • Endocardium • Valves • Myocardium • Pericardium • To the right are sterile vegetations on acutely inflamed valves • Can embolize • Will lead to scaring
  36. 36. HEALED RHEUMATIC CARDITIS • Scared and stenotic mitral and aortic valves. • Old sites of inflammation in myocardium • Aschoff nodules • Scars of pericarditis
  37. 37. HEALED RHEUMATIC MITRAL VALVE • Scarred valve. • Both stenotic and incompetent. • ‘Fish mouth’ • This valve is a set up for infections.
  38. 38. RHEUMATIC VALVULAR DISEASE
  39. 39. MARFAN’S SYNDROME • Inherited disorder of elastic tissue • Dilated aorta, dissection and rupture. • Incompetent aortic valve. • Mitral valve stretches • Lenses can’t accommodate.
  40. 40. MITRAL VALVE PROLAPSE • Myxoid degeneration of valve matrix. • Stretches under pressure of left ventricle. • Parachute deformity • The one to the right has a ruptured cordae tendinae
  41. 41. INFECTIVE ENDOCARDITIS • Living bacteria on the valves • Previously damaged valves are at greater risk. • Destroys valve • Embolize the junk
  42. 42. INFECTIVE ENDOCARDITIS • Living bacteria on the valves • Previously damaged valves are at greater risk. • Destroys valve • Embolize the junk
  43. 43. CARDIOMYOPATHY • Weakened and, paradoxically, hyperplastic myocardium • ‘Primary’ means we don’t what causes it. • Secondary to something else. • Alcohol • Heavy metals • Virus?
  44. 44. MYOCARDITIS • Viruses mostly in US • Rarely bacteria of TB. • Parasites • Toxoplasmosis gondii • Trypanosoma cruzi • Complications • Heart failure • Rhythm disturbances • Scarring of muscle • Mural thrombus and embolization
  45. 45. PERICARDIAL DISEASE • Inflammation • Viral • Lyme disease • Renal Failure • Cancer • Effusions • CHF • Cancer • Fibrosis leading to restriction of heart motion
  46. 46. PERICARDITIS • Inflammation of epicardium and pericardium • Effusion (fluid) of pericardial space • Tamponade • May lead to serious scarring and restriction of heart motion.
  47. 47. HEMOPERICARDIUM • Ruptured or perforated heart • MI • Penetrating wounds • Lacerated aortic root • Auto accident • Rotatory motion unscrews heart from aorta

×