How and why the heart goes wrong

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How and why the heart goes wrong
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What there is to go wrong
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How and why the heart goes wrong
VALVES MUSCLE VESSELS ELECTRICS
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How and why the heart goes wrong
MUSCLE VALVES VESSELS ELECTRICS
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How and why the heart goes wrong
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How and why the heart goes wrong
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How and why the heart goes wrong

• MUSCLE
• Malformed
• connections
• holes
• Cardiomyopathy
• hypertrophic
• dilated
• restrictive
• Hypertensive disease
• Remodelling

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How and why the heart goes wrong

• VALVES
• Congenital
• malformed
• Acquired
• rheumatic fever
• infective endocarditis
• trauma
• degenerative
• floppy
• senile calcification

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Heart Valve lesions

• Mitral stenosis
• Aortic stenosis
• Pulmonary stenosis
• Tricuspid stenosis
• Prosthetic stenosis

• Mitral regurgitation
• Aortic regurgitation
• Pulmonary regurgitation
• Tricuspid regurgitation
• Prosthetic regurgitation

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MS echo
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Aortic Stenosis - aetiology

• Congenital bicuspid valve
• Acquired
• Rheumatic
• Senile/degenerative

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Aortic stenosis
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Echo AS
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AR - xray
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AR - Echo
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How and why the heart goes wrong

• VESSELS
• Malformed
• Atheromatous disease
• stenosis
• narrowing
• myocardial ischaemia
• angina
• occlusion
• blockage
• myocardial infarction
• dilatation
• aneurysmal
• dissection

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How and why the heart goes wrong

• ELECTRICS
• Malformed
• inadequate connection
• excessive connection
• Molecular
• instability
• Degenerative
• Bystander
• MI, infection, cardiomyopathy

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Sinus node disease
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AV node disease
Complete (3rd degree) heart block
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What there is to go wrong
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Atrial flutter
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Atrial fibrillation
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What there is to go wrong
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AV nodal re-entry tachycardia
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What there is to go wrong
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Ventricular tachycardia
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Torsades de Pointes
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Rhythm Strip During Episode of Sudden Death
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Implanatable defibrillator in-situ
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How and why the heart goes wrong
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How and why the heart goes wrong
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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)

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Mitral regurgitation pathophysiology

• Leaking mitral valve valve
• ? LV emptying
• ? LV filling
• ? LV dilatation
• LV stretch ? contractile failure muscle
• ? LA pressure
• LA stretch
• Atrial arrhythmia (atrial fibrillation) electrics
  
• Thrombo-embolic risk
• stroke (cerebrovascular accident)
• heart attack (myocardial infarct) vessels