RJS How and why the heart goes wrong. RJS What there is to go wrong.

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Presentation transcript:

RJS How and why the heart goes wrong

RJS What there is to go wrong

RJS How and why the heart goes wrong VALVES MUSCLE VESSELS ELECTRICS

RJS How and why the heart goes wrong MUSCLE VALVES VESSELS ELECTRICS

RJS How and why the heart goes wrong

RJS How and why the heart goes wrong

RJS How and why the heart goes wrong MUSCLE Malformed connections holes Cardiomyopathy hypertrophic dilated restrictive Hypertensive disease Remodelling

RJS How and why the heart goes wrong VALVES Congenital malformed Acquired rheumatic fever infective endocarditis trauma degenerative floppy senile calcification

RJS Heart Valve lesions Mitral stenosis Aortic stenosis Pulmonary stenosis Tricuspid stenosis Prosthetic stenosis Mitral regurgitation Aortic regurgitation Pulmonary regurgitation Tricuspid regurgitation Prosthetic regurgitation

RJS

MS echo

RJS Aortic Stenosis - aetiology Congenital – bicuspid valve Acquired –Rheumatic –Senile/degenerative

RJS Aortic stenosis

RJS Echo AS

RJS AR - xray

RJS AR - Echo

RJS How and why the heart goes wrong VESSELS Malformed Atheromatous disease stenosis narrowing myocardial ischaemia angina occlusion blockage myocardial infarction dilatation aneurysmal dissection

RJS

How and why the heart goes wrong ELECTRICS Malformed inadequate connection excessive connection Molecular instability Degenerative Bystander MI, infection, cardiomyopathy

RJS

Sinus node disease

RJS AV node disease Complete (3rd degree) heart block

RJS What there is to go wrong

RJS Atrial flutter

RJS Atrial fibrillation

RJS What there is to go wrong

RJS AV nodal re-entry tachycardia

RJS What there is to go wrong

RJS Ventricular tachycardia

RJS Torsades de Pointes

RJS Rhythm Strip During Episode of Sudden Death

RJS Implanatable defibrillator in-situ

RJS How and why the heart goes wrong

RJS

How and why the heart goes wrong

RJS Mitral regurgitation – pathophysiology Leaking mitral valve  LV emptying  LV filling  LV dilatation LV stretch  contractile failure  LA pressure LA stretch Atrial arrhythmia (atrial fibrillation) Thrombo-embolic risk –stroke (cerebrovascular accident) –heart attack (myocardial infarct)

RJS Mitral regurgitation – pathophysiology Leaking mitral valvevalve  LV emptying  LV filling  LV dilatation LV stretch  contractile failuremuscle  LA pressure LA stretch Atrial arrhythmia (atrial fibrillation)electrics Thrombo-embolic risk –stroke (cerebrovascular accident) –heart attack (myocardial infarct)vessels