心血管病理2PPT.pptVIP

2018-1-26 1 Major Symptom and Sign of Common Disease in Circulatory System 2018-1-26 2 Mitral Stenosis MS results from recurrent rheumatic activity. The flow of blood is damped from LA to LV in diastole, and LA pressure is increased , causing LA dilatation and hypertrophy. 2018-1-26 3 The high atrial pressure induces a dilatation and stasis of pulmonary vein and capillary. Pulmonary artery pressure increased gradually due to the increased pulmonary circulatory resistance. 2018-1-26 4 The right ventricle is overloaded and then the compensatory hypertrophy and dilatation occur. Right ventricular failure may be present finally. 2018-1-26 5 2018-1-26 8 Symptoms Exhausted dyspnea(劳力性呼吸困难) Occasional paroxysmal nocturnal dyspnea(夜间阵发性呼吸困难) Cough Hemoptysis(咯血) 2018-1-26 9 Signs Inspection: “Mitral Facies” may be present. The apical pulse may extend to left side. Palpation: diastolic thrill may be felt at apex. Percussion: The cardiac dullness extend to left in early stage and later to right. The cardiac silhouette is like a pear. 2018-1-26 10 Auscultation: A loud snappy first sound and a localized rumbling diastolicmurmur (舒张期隆隆样杂音) in the mid-late stage may be heard at apex. The opening snap may be present. The pulmonary second sound may be accentuated of splitting. 2018-1-26 11 2018-1-26 12 Mitral Insufficiency The main cause of MI is rheumatism, and MI may be produced by LV dilatation due to any cause. The blood regurgitation into LA from LV during systole. The filling degree and pressure of LA were augmented and then compensatory dilatation of LA occurs. 2018-1-26 13 LV accepts more blood flow during diastole. Over volume load results in LV hypertrophy and dilatation gradually. 2018-1-26 14 2018-1-26 15 2018-1-26 16 2018-1-26 17 Symptoms The patient may feel no symptom for a long time. The patient has fatigue and palpitation in the early stage. Exertional dyspnea happens in the terminal stage. 2018-1-26 18 Signs Inspection: The apical impulse is displaced to left an