This document summarizes several specific heart conditions:
- Congenital heart disease can cause excess deoxygenated blood in the systemic circulation or cause blood to pass through the lungs twice.
- In atrial septal defects, oxygenated blood passes through a hole in the atrial septum, causing no cyanosis. The murmur occurs during ventricular systole.
- In cardiac tamponade, fluid accumulates between the pericardial layers and preferentially compresses the right side of the heart.
Cardiac murmur is an abnormal heart sounds. can be heard with stethoscope or auscultation. the etiology of the cardiac murmur may be septal defect, valvular defects or vascular defects. the two main causes that lead to cardiac murmur, like stenosis and incompetence.
Cardiac murmur is an abnormal heart sounds. can be heard with stethoscope or auscultation. the etiology of the cardiac murmur may be septal defect, valvular defects or vascular defects. the two main causes that lead to cardiac murmur, like stenosis and incompetence.
Mitral stenosis is a narrowing of the mitral valve opening that blocks (obstructs) blood flow from the left atrium to the left ventricle. Mitral stenosis usually results from rheumatic fever, but infants can be born with the condition. Mitral stenosis does not cause symptoms unless it is severe
This slide explains about chambers,circulation and anatomy of heart. And also about the diseases of heart and blood vessels. gives explanation about diagnosis of the cardiovascular diseases, with both surgical and pharmacological treatment.
Mitral stenosis is a narrowing of the mitral valve opening that blocks (obstructs) blood flow from the left atrium to the left ventricle. Mitral stenosis usually results from rheumatic fever, but infants can be born with the condition. Mitral stenosis does not cause symptoms unless it is severe
This slide explains about chambers,circulation and anatomy of heart. And also about the diseases of heart and blood vessels. gives explanation about diagnosis of the cardiovascular diseases, with both surgical and pharmacological treatment.
overview of heart and its disease
The heart is a powerful muscle that pumps
blood throughout the body by means of a
coordinated contraction.
The contraction is generated by an
electrical activation, which is spread by a
wave of bioelectricity that propagates in a
coordinated manner throughout the
heart.
It is located in thoracic cavity,
posterior to the sternum ,superior
to the diaphragm between the
lungs.
A human heart beats an average of
100,000 times per day. During that
time, it pumps more than 4,300
gallons of blood throughout
the entire body.
EPICARDIUM:
It is the outer layer of the wall of the heart which is composed of
connective tissue covered by epithelium. It is also known as
visceral pericardium.
2) MYOCARDIUM:
It is the muscular middle layer of the wall of the heart. It is
composed of spontaneously contracting cardiac muscle fibers
which allow the heart to contract. It stimulates heart contraction
to pump blood from the ventricles and relaxes the heart to allow
the arteries to receive blood.
ENDOCARDIUM:
It is the inner layer of the heart which consist of epithelial
tissue and connective tissue.
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This ๐๐ก๐๐ฎ๐ฆ๐๐ญ๐ข๐ ๐๐๐๐ซ๐ญ ๐๐ข๐ฌ๐๐๐ฌ๐ (๐๐๐)animated template is designed by RxSlides, a medical professional team covering the following topics about ๐๐ก๐๐ฎ๐ฆ๐๐ญ๐ข๐ ๐๐๐๐ซ๐ญ ๐๐ข๐ฌ๐๐๐ฌ๐ (๐๐๐)
๐๐ก๐๐ฎ๐ฆ๐๐ญ๐ข๐ ๐๐๐๐ซ๐ญ ๐๐ข๐ฌ๐๐๐ฌ๐ (๐๐๐)
๐๐๐๐ข๐ง๐ข๐ญ๐ข๐จ๐ง
โข Chronic cardiovascular condition caused by untreated or inadequately treated group-A streptococcal infection.
Characteristics:
โข Permanent damage to heart valves.
โข Starts with pharyngitis caused by streptococcus pyogenes.
โข Affects heart valves, including pulmonary, mitral, tricuspid, and aortic.
๐ฉ๐ซ๐๐ฏ๐๐ฅ๐๐ง๐๐
โข High prevalence in low-income countries, particularly among children and young adults.
๐๐ข๐ฌ๐ค ๐ ๐๐๐ญ๐จ๐ซ๐ฌ
โข Inadequate healthcare access
โข Untreated streptococcal infections
โข Unfavorable environmental conditions
๐๐๐ญ๐ก๐จ๐ฉ๐ก๐ฒ๐ฌ๐ข๐จ๐ฅ๐จ๐ ๐ฒ:
โข Development of scar tissue on valves due to recurrent inflammation.
โข Commissural fusion: valves fuse and thicken.
โข Mitral stenosis: narrowing of mitral valve opening.
โข Valvular regurgitation: incomplete closure of valves, causing blood flow reversal.
โข Valvular stenosis: narrowing of valve opening, restricting blood flow.
๐๐จ๐ซ๐ญ๐ข๐ ๐๐๐ ๐ฎ๐ซ๐ ๐ข๐ญ๐๐ญ๐ข๐จ๐ง:
โข Cause: Damage to the aortic valve leaflets or supporting structures prevents proper closure during diastole, leading to blood flow back into the left ventricle.
โข Symptoms: Fatigue, shortness of breath, chest pain, palpitations, and heart failure in severe cases.
๐๐จ๐ซ๐ญ๐ข๐ ๐๐ญ๐๐ง๐จ๐ฌ๐ข๐ฌ:
โข Cause: Calcification and narrowing of the aortic valve opening restricts blood flow from the left ventricle to the aorta.
โข Symptoms: Fatigue, shortness of breath, chest pain, syncope (fainting), and angina (chest pain due to heart muscle ischemia).
๐๐ข๐ญ๐ซ๐๐ฅ ๐๐ญ๐๐ง๐จ๐ฌ๐ข๐ฌ:
โข Cause: Thickening and fusion of the mitral valve leaflets restrict blood flow from the left atrium to the left ventricle.
โข Symptoms: Fatigue, shortness of breath, especially on exertion, chest pain, and hemoptysis (coughing up blood) in severe cases.
๐๐ฒ๐ฆ๐ฉ๐ญ๐จ๐ฆ๐ฌ:
โข Chest pain
โข Swollen joints
โข Fever
โข Weariness
โข Heart palpitation
โข Skin nodules
๐๐ข๐๐ ๐ง๐จ๐ฌ๐ญ๐ข๐ ๐ฆ๐๐ญ๐ก๐จ๐๐ฌ
โข Magnetic resonance imaging (MRI)
โข X-ray
โข Electrocardiogram (ECG)
โข Echocardiogram
๐๐ซ๐๐๐ญ๐ฆ๐๐ง๐ญ ๐๐ฉ๐ญ๐ข๐จ๐ง๐ฌ
โข Surgery
โข Antibiotics
โข Lifelong prophylaxis
๐๐ซ๐๐ฏ๐๐ง๐ญ๐ข๐ฏ๐ ๐๐๐ญ๐ก๐จ๐๐ฌ:
โข Healthy lifestyle
โข Benzathine benzylpenicillin injections
โข Improved healthcare services
โข Preventing rheumatic fever
๐ต๐๐๐ฝ๐://๐๐๐.๐ฟ๐ ๐๐น๐ถ๐ฑ๐ฒ๐.๐ฐ๐ผ๐บ
1. SOME SPECIFIC HEART CONDITIONS
Congential heart disease
In cyanotic congenital (= existing from birth) heart disease there is excess
deoxygenated blood in the systemic circulation (because some blood bypasses the
lungs), whereas in non-cyanotic congenital heart disease blood does go through the
lungs (sometimes twice) but at the expense of the systemic circulation.
Atrial septal defect (Fig. 49)
In atrial septal defects oxygenated blood returns from the lungs into the left atrium,
passes through the defect into the (lower pressure) right atrium and thence (again) to
the lungs. Cyanosis thus does not occur in uncomplicated atrial septal defect.
In theory atrial septal defect murmurs should be heard during ventricular diastole
when the atria will be in systole (as if the murmur were exclusively caused by passage
of blood through the defect between the right and left atrium). In practice a murmur
generated at the defect itself is rarely audible because of the low pressures involved
and the largeness of most defects. The murmur of atrial septal defect occurs during
ventricular systole and is caused by the augmented blood volume passing through the
pulmonary valve (thus simulating a pulmonary stenosis murmur). The augmented
blood flow through the right heart may also cause a tricuspid flow murmur during
right ventricular filling.
Normally the second heart sound is split in inspiration with the aortic valve closing
before the pulmonary valve because of the higher aortic pressures. During inspiration
more blood can be accommodated in the lungs, this extra blood passes into the right
ventricle during ventricular relaxation which then caused prolonged right ventricular
contraction (it takes longer to eject the increased amount of blood). The prolonged
contraction time delays pulmonary valve closure. Thus a normal second heart sound
may be split and the split is normally accentuated during inspiration.
With an atrial septal defect the two atria can be regarded as one chamber and blood
flow into both ventricles is similar. Both ventricular contraction times are therefore
similar and both valve closures are delayed equally. Thus there is a split second
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2. sound which does not vary with respiration (fixed splitting). The right ventricle may
also enlarge.
Cardiac tamponade (Fig. 50)
Fluid accumulates between the two layers of pericardium. This fluid preferentially
compresses the right atrium and ventricle (which are at a lower internal pressure and
thus more easily compressed than their left sided counterparts). Impaired filling of
the heart, predominantly the right side during ventricular relaxation, is impaired. The
neck veins become distended particularly with inspiration as the expanded lungs
compress the heart further. Also less blood returns from the lungs to the left heart and
the pulse volume therefore falls in inspiration (pulsus paradoxus). The blood pressure
will be low and the heart rate fast because the heart attempts to maintain output by
increasing the number of fixed volume contractions. Treatment is usually by drainage
of the fluid.
Cardiomyopathy
With hypertrophic cardiomyopathy there is hypertrophy of the ventricular septum or
ventricular muscle. Ventricular contraction is distorted and ventricular filling during
ventricular diastole may be impaired. There may be an abrupt carotid pulse because
there is an abrupt obstruction to left ventricular emptying. With restrictive
cardiomyopathy ventricular filling is restricted because of ventricular muscle
abnormality. This produces symptoms and signs similar to those of constrictive
pericarditis.
2
3. Constrictive pericarditis (Fig. 51)
The heart is imprisoned by the tight outer layer of pericardium.
Fallotโs tetrad (Fig.52)
This illustrates one congenital heart problem which is explicable on an embryological
basis. The basic feature is that the truncus does not divide appropriately into the aorta
and pulmonary arteries with:
โข The pulmonary artery being poorly developed
โข The aorta straddling the interventricular septum
โข Failure of the interventricular septum to develop fully resulting in a ventricular
septal defect
โข Pressure in the left and right ventricles tends to be equal (a combined effect of the
ventricular septal defect and the pulmonary stenosis) with the right ventricle thus
becoming hypertrophied
3
4. Infective endocarditis
Micro-organisms, almost invariably bacteria, infect heart valves, causing them to be
incompetent. Infective endocarditis may have a rapid onset when caused by virulent
micro-organisms which may affect normal heart valves. Infective endocarditis caused
by less virulent micro-organisms may develop slowly and usually only affects
previously damaged valves. Right sided endocarditis is a particular risk for
intravenous drug abusers who usually inject into veins.
Ischaemic heart disease
Ischaemia (= a local and temporary deficiency of blood caused by interruption of the
blood supply) is almost always associated with coronary artery atheroma. Intrinsic
heart muscle disease or overdevelopment of ventricular muscle caused by overwork
can outstrip the available blood supply to cause ischaemic symptoms.
Heart muscle has a limited ability to metabolise without oxygen and increased oxygen
demands caused by increased work have to be met by increased blood flow brought
about by coronary artery vasodilatation (which may be able to compensate for
narrowing caused by atheroma).
When heart muscle is starved of oxygen angina (a pressing, constricting discomfort
or pain which is brought on by exertion and relieved by rest) may result. Angina may
also be felt in the left arm, which has a similar somatic nerve supply as the autonomic
supply to the heart. Treatments of an anginal attack includes stopping the causative
activity, sitting down and using a nitrate preparation which dilates peripheral arteries
and thereby reduces the afterload.
4
5. Myocardial infarction
Myocardial infarction (infarction = muscle death) occurs when ischaemic heart
muscle dies. Myocardial infarction causes about 200,000 deaths a year in the United
Kingdom. Symptoms may be similar to angina but may begin at rest, last for longer
(more than 20 minutes) and be more severe.
Treatment of myocardial infarction may include:
โข Pain relief
โข Aspirin to reduce clotting
โข Early attempts to dissolve the thrombus (thrombolysis)
โข Interventions include drugs to dilate blood vessels to reduce heart workload, and
drugs that reduce heart work by direct action on heart muscle
Patent ductus arteriosus (Fig. 53)
If the ductus arteriosus fails to close at birth then blood will flow continuously from
the aorta into the pulmonary veins because the aortic pressure after birth is higher
than pulmonary vein pressure at all stages of the cardiac cycle. Blood in the aorta is
always fully oxygenated and therefore patients do not develop cyanosis. There is a
wide pulse pressure because the aortic diastolic pressure is lower than normal due to
the continued drainage of blood from the aorta into the pulmonary artery.
Pregnancy and the heart
Pregnancy may exacerbate heart failure because in pregnancy there is:
โข An increased cardiac output
โข An increased blood and extracellular volume
โข A slightly increased heart rate
โข A 30 percent increase in heart oxygen requirement
5