Septal Defects University of OttawaAV间隔缺损渥太华大学ppt课件.pptVIP

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Septal Defects University of OttawaAV间隔缺损渥太华大学ppt课件.ppt

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Septal Defects University of OttawaAV间隔缺损渥太华大学ppt课件

Aortic valve - normal Mitral valve - normal Aortic stenosis - causes Aortic stenosis causing LVH Mitral stenosis - rheumatic Floppy mitral valve - mitral valve prolapse (MVP) Hypertension PRIMARY (ESSENTIAL) Genetic and environmental factors Defects in sodium homeostasis, vascular smooth muscle structure, regulation of vascular tone SECONDARY renal disease vascular disease endocrinopathies drugs neurogenic etc… Dissecting “aneurysm” Coronary artery aneurysms secondary to vasculitis (inflammation of blood vessels) Left atrium Right ventricle Left ventricle Right atrium Pericardium Right lung Left lung Aorta SVC Right atrium Left atrium Right ventricle Left ventricle Interventricular septum Coronary artery anatomy /diagnoseCAD.html Coronary artery atherosclerosis affects the epicardial arteries; tends to be more pronounced in the proximal portion of these vessels can involve 1, 2 or all 3 of the main vessels +/- their large branches if degree of obstruction is significant, can result in angina (pain from myocardial ischemia) an atherosclerotic plaque can become unstable (acute plaque lesion): intraplaque hemorrhage plaque rupture or erosion resulting in thrombosis acute plaque lesions can result in an “acute coronary syndrome” (unstable angina, myocardial infarct) Myocardial infarct terminology Recent MI - about 24 hours old Contraction band necrosis Recent MI - about 3 days old Recent MI - interstitial infiltrate of neutrophils Recent MI - 5-7 days old Recent MI - 7-10 days old Residual necrotic myocytes Phagocytosis of dead cells at margin of infarct “Sick” myocytes bordering the infarct Remote myocardial infarcts Transmural rupture Infarct rupture and tamponade Papillary muscle rupture Left ventricle aneurysm Ischemic heart disease - interventions Non-surgical thrombolysis PTCA / stenting atherectomy rotablation Surgical Coronary Artery Bypass Grafting (CABG) – typically using saphenous vein grafts and/or internal thoracic arteries endarterectomy Atherectomy