Anatomy of heart- Four chambers 1.Rt.atrium 2.Rt.ventricle 3.Lt.atrium 4.Lt.ventricle Two great arteries- 1.Aorta 2.Pulmonary arteries Pericardium. 1.Parietal 2.Visceral Chambers are as following- Right atrium : Chamber receives systemic venous drainage through SVC and IVC Coronary venous drainage through coronary sinus Important characteristics for identification: Limbus for fossa ovalis Wide based blunt ended Right sided atrial […]
Continue ReadingMyocardial Revascularisation
Defination: The restoration of an adequate blood supply to a part of heart by means of a blood vessel graft [ aortocoronary bypass] or stenting the plaque site. Anatomy of coronary arteries: Aortic root- Aortic root contains 3 cusps – Rt.coronary,Lt.coronary and non-coronary from first two cusps respective coronary arteries arises. Coronary arterial circulation- Rt coronary artery Arises from Rt sinus of valsalva of aortic root. Best seen in Lt anterior oblique view […]
Continue ReadingMitral Valve and Pathology
Mitral Stenosis [MS] ☛ Etiology – congenital / Acquired [adult ] ☛ Congenital MS is very rare .Associated with other anomalies as shave’s complex ☛ Acquired – Moss common is Rheumatic heart disease ☛ 25% rheumatic heart disease pure MS. ☛ 40% have MS with MR. ☛ 10% have pure MR. Rare causes are Systemic […]
Continue ReadingPressure volume loop in valvular heart disease
Aortic Regurgitation As ventricle relaxes blood from aortic flow back into ventricle so no true isovolumetric relaxation,so ventricle gets filled before mitral valve opens,throughout diastole ventricle gets filled from aorta so end diastolic volume is increased as shown in PV loop By chronic dilatation of ventricle EDV increases No true isovolumetric contraction as blood […]
Continue ReadingPeripheral Signs of AR
Classical signs for severe aortic regurgitation are as follows- 1.WIDE PULSE PRESSURE ☛ Mild 40-60 mmHg ☛ Moderate 60-80 mmHg ☛ Severe > 80 mmHg 2.HILLS SIGN ☛ difference between systolic BP in LL & UL ☛ Mild AR- 20-40 mmHg ☛ Mod- 40-60 mmHg ☛ Sev- >60 mmHg 3.ALFRED DE MUSET SIGN ☛ Oscillation […]
Continue ReadingIPC-Ischemic Preconditioning
Ischemic preconditioning: Inhalational and opiod induced ischemic preconditioning as following Defn: Ischaemic preconditioning involves – brief period of (1 to 4sec.)occlusion of artery & the same period of reperfusion before performing the anastomosis. Ischaemic preconditioning can be done, By surgeons occluding the artery before starting the actual anastomosis. Inhalational anaesthetics are also proved to be […]
Continue ReadingLow Cardiac Output Syndrome
Introduction Low cardiac output syndrome is one of the complication in post op cardiac surgeries in adult as well as paediatric surgeries. Myocardial function generally decline after 6-8hrs of post CPB/post revascularization surgery because of ischaemic reperfusion injury. Definition – Low cardiac output state can be defined as cardiac index below 2 lits/min/m2,associated with lt. […]
Continue ReadingRt Ventricular Failure and Pulmonary Hypertension
Low cardiac output can be because of Rt. Ventricular failure and pulmonary hypertension. Preexisting conditions leading to this are- Rt.coronary artery disease, Rt.ventricular infarction, pulmonary hypertension. Etiology Poor myocardial protection . Prolong ischaemic time or myocardial stunning. Coronary embolism of air.thrombi or particulate matter. Systolic hypotension which causes RV ischaemia. Acute pulmonary hypertension […]
Continue ReadingHeart Failure
ACC & AHA Definition- Heart failure as a clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. Because volume overload is not necessary to be present ,the term Heart Failure(HF) is preferred to be term congestive Heart failure. Systolic […]
Continue ReadingMarfan’s Syndrome
☛ 1896-Autine Marfan ☛ 65-70%genetic transmission-mutation of FBN1 gene on chromosome 15 Criterias ☛ Main systems get affected ☛ Skeletal,CVS, occular, skin,pulmonary Ghent diagnostic criteria For skeletal system MAJOR MINOR Pectus excavatum/carinatum Mild pectus excavatum Upper segment/lower segment <0.8 High arched palate Arm span/height >1.05 Oblong head Walker murdoch sign-(wrist sign)-little Endophthalmos Finger touch […]
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