DOCSLIB.ORG

1. a Aorta B. Pulmonary Valve C. Superior Vena Cava D

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
1. a Aorta B. Pulmonary Valve C. Superior Vena Cava D 20. Anatomy of the Heart Answers to Pre- Lab Assignments Pre-Lab Activity 1: 1. a aorta b. pulmonary valve c. superior vena cava d. right atrium e. tricuspid valve f. right ventricle g. pulmonary trunk h. left atrium i. aortic valve j. mitral (bicuspid) valve k. left ventricle 2. a. 6 b. 1 c. 5 d. 7 e. 9 f. 2 g. 4 h. 8 i. 3 Pre-Lab Activity 2: 1. apex inferior to base; large vessels arise from base 2. epicardium (circled), myocardium, endocardium 3. coronal (frontal) Pre-Lab Activity 3: 1. a – cardiac muscle fibers b – striations c – intercalated disc d – nucleus 2. b Pre-Lab Activity 4: 1. d 2. b 3. c Answers to Activity Questions Activity 1 Making Connections: Heart Anatomy Structure Description (Structure and/or Function) Connections to Things I Have Already Learned Epicardium Outer layer of heart wall Also called visceral pericardium, the innermost layer of the serous pericardium Myocardium Middle layer of heart wall; predominantly cardiac “myo” = muscle muscle tissue myoglobin, myofilament Endocardium Inner layer of the heart wall Other terms with “endo” prefix: endomysium, en- doneurium, endothelium Right atrium Thin-walled receiving chamber that receives blood Contains SA node (pacemaker). from the superior vena cava, inferior vena cava, and coronary sinus Right ventricle Pumps deoxygenated blood to lungs via the pulmo- Separated from left ventricle by interventricular nary trunk. septum. Left atrium Receives oxygenated blood from the pulmonary An atrium is an entry chamber. veins. Left ventricle Pumps oxygenated blood to the body via the aorta. Supplied by anterior and posterior interventricular arteries. Tricuspid valve Prevents backflow of blood from the right ventricle Also called right atrioventricular valve. to the right atrium. Mitral (bicuspid) Prevents backflow of blood from the left ventricle to Also called left atrioventricular valve. valve the left atrium. Pulmonary trunk Transports deoxygenated blood from the right ven- A trunk is a blood vessel that gives rise to other tricle to the lungs. blood vessels. Pulmonary valve Prevents backflow of blood from the pulmonary Opens when right ventricular pressure exceeds trunk to the right ventricle. pressure in pulmonary trunk. Aorta Transports oxygenated blood from the left ventricle Descending aorta is divided into thoracic aorta • Ascending to the body. (above diaphragm) and abdominal aorta (below aorta diaphragm). • Aortic arch • Descending aorta Aortic valve Prevents backflow of blood from the aorta to left Opens when left ventricular pressure exceeds pres- ventricle. sure in aorta. Chordae tendineae Anchor atrioventricular valves to papillary muscles Literally means “heart strings.” of heart wall. Papillary muscle Contracts to prevent AV valves from inverting. Three in the right ventricle and two in the left ven- tricle; attach to cusps of AV valves. Coronary sinus Collects venous blood from cardiac veins and returns A sinus is an enlarged vein. Superior sagittal sinus it to the right atrium. collects venous blood in brain. Inferior vena cava Large vein that receives deoxygenated blood from Right and left common iliac veins fuse to form it. the lower body and returns it to the right atrium Superior vena cava Large vein that receives deoxygenated blood from Right and left brachiocephalic veins fuse to form it. the upper body and returns it to the right atrium Pulmonary veins Return oxygenated blood from the lungs to the left Exception to the rule that veins carry deoxygenat- atrium. ed blood. Fossa ovalis Depression in interatrial septum; remnant of the fo- Fossa = depression; ovalis = oval shaped; foramen ramen ovale ovale shunts blood from right atrium to left atrium in fetus. Ligamentum arte- Band of fibrous connective tissue between pulmo- Ductus arteriosus shunts blood from pulmonary riosum nary trunk and aorta; remnant of the ductus arterio- trunk to aorta in fetus. sus. Activity 2 A. External Anatomy 3. a. Aorta carries oxygenated blood from the LV to all parts of the body. b. Pulmonary trunk carries deoxygenated blood from RV to lungs. c. Superior vena cava returns deoxygenated blood to RA. d. Inferior vena cava returns deoxygenated blood to RA. e. Pulmonary veins return oxygenated blood from the lungs to the LA. f. Ventricles are thick-walled pumping chambers. g. Atria are thin-walled receiving chambers. How do the locations of the superior and inferior venae cavae in a sheep heart differ from those of the human heart? In the sheep, they project ante- riorly and posteriorly instead of superiorly and inferiorly. 4. Predict the function of the anterior interventricular ar- tery. Supplies the ventricles with blood Predict the function of the cardiac vein. Collects venous blood from ventricles. B. Internal Anatomy 2. a. Epicardium produces serous fluid. b. Myocardium contracts to pump blood. c. Endocardium provides smooth surface for blood flow. d. Interventricular septum separates left and right ventricles. e. Tricuspid valve prevents backflow of blood from RV to RA. f. Bicuspid valve prevents backflow of blood from LV to LA. g. Pulmonary valve prevents backflow of blood from pulmonary trunk to RV. h. Aortic valve prevents backflow of blood from aorta to LV i. Chordae tendineae anchor valve to ventricular wall. j. Papillary muscles contract to prevent inversion of valve. Compare and contrast the structure of the tricuspid and bicuspid valves. Tricuspid contains three cusps (flaps), whereas bicuspid contains two cusps. Compare and contrast the structure of the right and left ventricles. Left ven- tricular wall is much thicker due to function of pumping blood to all parts of the body. Activity 3 1. Cardiac muscle tissue makes up the bulk of which heart wall layer? myocardium Describe the appearance of cardiac muscle fibers. short, branched cells; uninucleate; striated; intercalated discs 2. a. Gap junctions—allow communication among cardiac muscle fibers; ions able to move from one cell to another. b. Desmosomes—anchor cells together so that they do not tear apart during contraction. 3. Both are striated, both are packed with actin and myosin. 4. Skeletal muscle is under voluntary control; cardiac muscle is under involuntary control. Skeletal muscle fibers are long, cylindrical, and mul- tinucleate; cardiac muscle fibers are short, branched, and uninucleate. Activity 4 No questions Answers to POST- Lab ASSIGNMENTS PART I. Check Your Understanding Activity 1: Examining the Functional Anatomy of the Heart 1. Identify the components of the heart. a. superior vena cava b. right atrium c. tricuspid valve d. right ventricle e. interventricular septum f. aorta g. pulmonary trunk h. pulmonary valve i. pulmonary veins j. aortic arch k. bicuspid valve l. left ventricle 2. Which heart structure(s): chordae tendineae a. anchor atrioventricular valves to the heart wall? pulmonary veins b. receive oxygenated blood from the lungs? interventricular septum c. separates the right and left ventricles? right ventricle d. pumps blood to the lungs? right atrium e. receives blood from the coronary sinus? bicuspid valve f. prevents backflow of blood into the left ventri- cle? fossa ovalis g. is a remnant of the foramen ovale? tricuspid valve h. prevents backflow of blood into the right atri- um? Activity 2: Dissecting a Mammalian Heart 1. Identify the components of the sheep heart. a. aorta b. right atrium c. tricuspid valve d. right ventricle e. left atrium f. bicuspid valve g. left ventricle h. interventricular septum i. epicardium j. myocardium k. endocardium Activity 3: Reviewing the Microscopic Structure of Cardiac Muscle Tissue 1. Describe the appearance of a cardiac muscle fi- ber. uninucleate, striated, short, branched _______________________________________________________________ ________ 2. What causes the striations in these cells? arrangement of ac- tin and myosin__________ _______________________________________________________________ _______ 3. What are two functions of an intercalated disc? anchor cells (desmosomes) and allow •communication between cells (gap junc- tions) __________________________________ Activity 4: Tracing Circulatory Pathways 1. Trace the pathway of blood from the heart (left ventricle) to the right adrenal gland and back to the left ventricle → ascending aorta → aortic arch → thoracic aorta → abdominal aorta → right suprarenal artery → right adrenal gland → right su- prarenal vein → inferior vena cava → right atrium»heart (right atrium). _____________________ 2. List the structures of the coronary pathway serving the anteri- or ventricular wall in order, beginning in the left ventricle and ending in the right atrium. left ventricle → ascending aorta → left coronary artery → ante- rior interventricular artery → anterior interventricular wall → great cardiac vein → coronary sinus → right atrium _______ 3. Identify the events of the pulmonary and systemic circulations in the accompanying illustration. Color blood vessels containing oxygenated blood red, color blood vessels containing deoxygenated blood blue, and color capillary beds purple. a. Materials are exchanged at •capillary beds. ________________________________ b. Deoxygenated blood enters right atrium. ________________________________ c. Deoxygenated blood flows through tricuspid valve to RV. ________________________________ d. RV pumps blood through pulmonary valve to pulmonary trunk. ________________________________ e. Gas exchange occurs in the lungs. ________________________________ f. Oxygenated blood enters LA via the pulmonary veins. ________________________________ g. Oxygenated
Load more

Recommended publications
  • Blood Flow DHO8 7.8, Pg
    Blood Flow DHO8 7.8, pg. 190 HS1/2017-2018 Circuits •Pulmonary circuit –The blood pathway between the right of the heart, to the lungs, and back to the left side of the heart. •Systemic circuit –The pathway between the left side of the heart, to the body, and back to the right side of the heart. The Pathway of Blood •Superior & Inferior Vena •Left Atrium Cava •Mitral Valve •Right Atrium •Left Ventricle •Tricuspid Valve •Aortic Semilunar Valve •Right Ventricle •Aorta •Pulmonary Semilunar -Arteries Valve -Arterioles •Pulmonary Artery -Capillaries •Lungs -Venules –Pulmonary Arterioles -Veins –Pulmonary Capillaries –Pulmonary Venules •Pulmonary Vein Blood Flow Through Heart Do You Know? • When blood leaves the left atrium, where does it go next? a) Aorta b) Left ventricle c) Right atrium d) Pulmonary artery And the answer is….A Do You Know? • After blood leaves the right atrium, what valve prevents the back flow? a) Pulmonary b) Mitral c) Tricuspid d) Aortic And the answer is…C Do You Know? • The right ventricle is the chamber of the heart that pumps blood for the pulmonary circulation. Based on this information, blood from the right ventricle is on its way to the _____. a) Liver b) Lungs c) Hands and feet And the answer is…B Do You Know? • Which of the following is correct order of blood flow for the right side of the heart? a) RA, Tricuspid valve, RV, PSLV, pulmonary artery b) RA, PSLV, RV, Tricuspid valve, pulmonary artery c) RA, Tricuspid valve, RV, pulmonary artery , PSLV And the answer is…A Do You Know? • Which of the following is correct order of blood flow for the left side of the heart? a) LA, Bicuspid valve, LV, ASLV, aorta b) LA, ASLV, LV, Bicuspid valve, aorta c) LA, Bicuspid valve, LV, ASLV, aorta And the answer is…C.
    [Show full text]
  • Anatomy and Physiology of the Tricuspid Valve
    JACC: CARDIOVASCULAR IMAGING VOL. 12, NO. 3, 2019 ª 2019 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION PUBLISHED BY ELSEVIER STATE-OF-THE-ART PAPER Anatomy and Physiology of the Tricuspid Valve a,b c c a,b Abdellaziz Dahou, MD, PHD, Dmitry Levin, BA, Mark Reisman, MD, Rebecca T. Hahn, MD SUMMARY An appreciation of the complex and variable anatomy of the tricuspid valve is essential to unraveling the pathophysiology of tricuspid regurgitation. A greater appreciation of normal and abnormal anatomy is important as new methods of treating the tricuspid regurgitation are developed. This review of tricuspid valve and right heart anatomy is followed by a discussion of the possible pathophysiology of secondary (functional) tricuspid regurgitation. (J Am Coll Cardiol Img 2019;12:458–68) © 2019 by the American College of Cardiology Foundation. ith the recognition of the impact of components: the leaflets, the papillary muscles, the W tricuspid regurgitation (TR) on outcomes chordal attachments, and the annulus (with attached in a number of disease states (1–5),inter- atrium and ventricle) (7,12–16).Theleaflets and their est in understanding this disease process has grown. relationship to the chordae and papillary muscle play To help understand the pathophysiology of TR and an important role in TV closure during systole but the role of interventions in treatment of the disease, also may be integrally related to RV size and function. an appreciation of the complex and variable anatomy TRICUSPID VALVE LEAFLETS. Although the TV is – ofthetricuspidvalve(TV)isessential(6 12).Thispa- typically composed of 3 leaflets of unequal size, in per reviews tricuspid and right heart anatomy, dis- many cases, 2 (bicuspid) or more than 3 leaflets may cusses the pathophysiology of secondary TR, be present as anatomic variants in healthy subjects summarizes the anatomic structures relevant to inter- (6,9) (Figure 2).
    [Show full text]
  • Heart Valve Disease: Mitral and Tricuspid Valves
    Heart Valve Disease: Mitral and Tricuspid Valves Heart anatomy The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. The left side of the heart receives the oxygen- rich blood from the lungs and pumps it to the body. The heart has four chambers and four valves that regulate blood flow. The upper chambers are called the left and right atria, and the lower chambers are called the left and right ventricles. The mitral valve is located on the left side of the heart, between the left atrium and the left ventricle. This valve has two leaflets that allow blood to flow from the lungs to the heart. The tricuspid valve is located on the right side of the heart, between the right atrium and the right ventricle. This valve has three leaflets and its function is to Cardiac Surgery-MATRIx Program -1- prevent blood from leaking back into the right atrium. What is heart valve disease? In heart valve disease, one or more of the valves in your heart does not open or close properly. Heart valve problems may include: • Regurgitation (also called insufficiency)- In this condition, the valve leaflets don't close properly, causing blood to leak backward in your heart. • Stenosis- In valve stenosis, your valve leaflets become thick or stiff, and do not open wide enough. This reduces blood flow through the valve. Blausen.com staff-Own work, CC BY 3.0 Mitral valve disease The most common problems affecting the mitral valve are the inability for the valve to completely open (stenosis) or close (regurgitation).
    [Show full text]
  • Heart and Circulatory System Heart Chambers
    7 Southwoods Blvd. Albany, NY 12211 www.CaptialCardiology.com 518-292-6000 Anatomy of the Heart Overview The heart is a muscular organ that pumps blood HEART AND throughout your body. It is positioned behind the CIRCULATORY SYSTEM lungs, slightly to the left side of the chest. Your heart is a bit larger than the size of your fist. Let's examine the structures of the heart and learn how blood travels through this complex organ. Right Side The heart is divided into two sides and four chambers. On the right side, blood that has already circulated through the body enters the heart through the superior vena cava and the inferior vena cava. The blood flows into the right atrium. When this chamber is full, the heart pushes the blood through the tricuspid valve and into the the next chamber - the right ventricle. From there, the blood is pushed out of the heart through the pulmonary valve. The blood travels through the pulmonary artery to the lungs, where it will pick up oxygen and give up carbon dioxide. HEART CHAMBERS Left Side On the left side of the heart, blood that has received oxygen from the lungs enters the heart through the pulmonary veins. The blood flows into the left atrium. It is pushed through the mitral valve into the left ventricle. Finally, it is pushed through the aortic valve and into the aorta. The aorta is the body's largest artery. It helps distribute the oxygen-rich Right Left blood throughout the body. Valves Now let's take a closer look at the valves.
    [Show full text]
  • Tricuspid Valve Repair with Autologous Pericardium in a Patient with Infective Endocarditis
    CASE REPORT Braz J Cardiovasc Surg 2019 - Ahead of print: 1-3 Tricuspid Valve Repair with Autologous Pericardium in a Patient with Infective Endocarditis Henry Leonardo Robayo Amórtegui1,2, MD; Javier Páez Cristancho1,2, MD; Igor Donís-Gómez2, MD DOI: 10.21470/1678-9741-2019-0287 Abstract Infective endocarditis is a rather uncommon disease, but it has performed with a fenestrated autologous pericardium patch, significant mortality rates in the pediatric population (5% to 10%). providing satisfactory outcomes. This technique is simple, We report a case of an infant patient with multiple vegetation innovative, effective, and it could be applied in similar cases. in the tricuspid valve secondary to infective endocarditis caused Keywords: Tricuspid Valve. Child. Corynebacterium Diphtheriae. by Corynebacterium diphtheriae. A tricuspid valvuloplasty was Endocarditis, Bacteria. Cardiac Surgical Procedures. Pericardium. Abbreviations, acronyms & symbols CASE REPORT A three-year-old male patient was admitted with a two- IE = Infective endocarditis month history of abdominal pain, intermittent fever, asthenia, and NV = Neovalve adynamia. During physical examination, he presented jaundice, RA = Right atrium II/IV tricuspid murmur, and generalized swelling. Blood cultures isolated Corynebacterium diphtheriae. Echocardiography revealed a deformed and enlarged tricuspid valve with multiple vegetation in both anterior and posterior leaflets. One of them was as big as to prolapse the right ventricle, as it had a 12 mm diameter and III/IV INTRODUCTION grade insufficiency with pulmonary systolic pressure of 42 mmHg. Five to 36% of infective endocarditis (IE) cases involve the The pediatric cardiovascular surgical service opted for tricuspid valve[1]. With an incidence of 0.05 cases to 0.12 cases per performing urgent surgical intervention, given the sepsis 1,000 habitants, IE is a rather uncommon disease in the pediatric persistence and risk for an embolic event due to the vegetation.
    [Show full text]
  • Anatomy of the Conduction System
    II. CONDUCTION SYSTEM ANATOMY The functions of the electrical system of the heart (Fig. II-1) are not only initiation and rate of the heartbeat, but its coordinated transmission to the entire heart resulting in maximum mechanical efficiency. Anatomy of the conduction system left at rium SV C His Bundle Sinus Node mitral valve right atrium Left Bundle Branch AV Node left vent ricle tricuspid valve Right Bundle Branch IVC Purkinje Fibers right ventricle Fig. II-1. Conduction system anatomy; specialized conduction tissues labeled in bold type. A. Sinus node and atrium The heartbeat is normally begun in cells of the sinoatrial (SA), or sinus, node which is located in the high lateral right atrium where it adjoins the superior vena cava (embryonic sinus venosus region) (Fig. II-2). Blood supply is from the right coronary artery in 55% of cases, the circumflex branch of the left coronary artery in 45%. Impulses spread from the sinus node over the atria, from right to left/top to bottom, completing atrial depolarization in about 80-100 ms.. Although there are bundles of atrial tissue to which some have ascribed enhanced conduction properties, there are probably really no specialized interatrial tracts (i.e., like the Purkinje fibers). Function of the sinus node is influenced profoundly by autonomic nervous system tone – increases in parasympathetic tone decrease automaticity of the sinus node, slowing the heart rate, while increases in sympathetic tone increase automaticity, resulting in increased heart rate. Fig. II-2. Anatomy of the human sinoatrial (SA) node. In most hearts the node is located in the terminal groove lateral to the superior cavoatrial junction, but in 10% of hearts it is a horseshoe- shaped structure straddling the crest of the atrial appendage.
    [Show full text]
  • Anatomy and Physiology of the Cardiovascular System
    Chapter © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC 5 NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Anatomy© Jonesand & Physiology Bartlett Learning, LLC of © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION the Cardiovascular System © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION © Jones & Bartlett Learning, LLC © Jones & Bartlett Learning, LLC NOT FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION OUTLINE Aortic arch: The second section of the aorta; it branches into Introduction the brachiocephalic trunk, left common carotid artery, and The Heart left subclavian artery. Structures of the Heart Aortic valve: Located at the base of the aorta, the aortic Conduction System© Jones & Bartlett Learning, LLCvalve has three cusps and opens© Jonesto allow blood & Bartlett to leave the Learning, LLC Functions of the HeartNOT FOR SALE OR DISTRIBUTIONleft ventricle during contraction.NOT FOR SALE OR DISTRIBUTION The Blood Vessels and Circulation Arteries: Elastic vessels able to carry blood away from the Blood Vessels heart under high pressure. Blood Pressure Arterioles: Subdivisions of arteries; they are thinner and have Blood Circulation muscles that are innervated by the sympathetic nervous Summary© Jones & Bartlett Learning, LLC system. © Jones & Bartlett Learning, LLC Atria: The upper chambers of the heart; they receive blood CriticalNOT Thinking FOR SALE OR DISTRIBUTION NOT FOR SALE OR DISTRIBUTION Websites returning to the heart. Review Questions Atrioventricular node (AV node): A mass of specialized tissue located in the inferior interatrial septum beneath OBJECTIVES the endocardium; it provides the only normal conduction pathway between the atrial and ventricular syncytia.
    [Show full text]
  • Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, in Vivo and in Vitro Investigations, To
    bioengineering Review Mechanics of the Tricuspid Valve—From Clinical Diagnosis/Treatment, In-Vivo and In-Vitro Investigations, to Patient-Specific Biomechanical Modeling Chung-Hao Lee 1,2,* , Devin W. Laurence 1 , Colton J. Ross 1, Katherine E. Kramer 1, Anju R. Babu 1,3 , Emily L. Johnson 4, Ming-Chen Hsu 4,* , Ankush Aggarwal 5 , Arshid Mir 6, Harold M. Burkhart 7, Rheal A. Towner 8, Ryan Baumwart 9 and Yi Wu 1 1 Biomechanics and Biomaterials Design Laboratory, School of Aerospace and Mechanical Engineering, The University of Oklahoma, Norman, OK 73019, USA; [email protected] (D.W.L.); [email protected] (C.J.R.); [email protected] (K.E.K.); [email protected] (A.R.B.); [email protected] (Y.W.) 2 Institute for Biomedical Engineering, Science and Technology (IBEST), The University of Oklahoma, Norman, OK 73019, USA 3 Department of Biotechnology and Medical Engineering, National Institute of Technology Rourkela, Rourkela, Odisha 769008, India 4 Department of Mechanical Engineering, Iowa State University, Ames, IA 50011, USA; [email protected] 5 Glasgow Computational Engineering Centre, School of Engineering, University of Glasgow, Scotland G12 8LT, UK; [email protected] 6 Division of Pediatric Cardiology, Department of Pediatrics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; [email protected] 7 Division of Cardiothoracic Surgery, Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; [email protected] 8 Advance Magnetic Resonance Center,
    [Show full text]
  • Straddling Tricuspid Valve'
    Br Heart J: first published as 10.1136/hrt.36.8.747 on 1 August 1974. Downloaded from British Heart_Journal, I974, 36, 747-759. Double inlet left ventricle Straddling tricuspid valve' Rajendra Tandon,2 Anton E. Becker, James H. Moller, and Jesse E. Edwards From the Department of Pathology, United Hospitals - Miller Division, St. Paul, Minnesota; the Depart- ments of Pathology and Pediatrics, University of Minnesota, Minneapolis, Minnesota; and the Department of Pathology, University of Amsterdam, The Netherlands Eleven cases of double inlet left ventricle have been presented. Double inlet left ventricle is characterized by the tricuspid valve opening partly (partial type) or completely (complete type) into the morphological left ventricle. The morphological right ventricle is usually hypoplastic but may be normallyformed. Even when the right ventricle is hypoplastic, both the sinus and the outflow portions of the right ventricle are recognizable. Double inlet left ventricle has been classified into two groups according to whether the ventricles are nor- mallyplaced (noninverted; concordant with the atria) or inverted (discordant with the atria.) This classification indicates the anatomicalrelation of the atrioventricular valves and the ventricles. When the ventricles are non- inverted, a right-to-left shunt resultsfrom the communication of the right atrium with the left ventricle. On the other hand, with inverted ventricles a left-to-right shunt resultsfrom the left atrium communicating with the inverted left ventricle. Further details in circulation depend upon the great vessel-ventricular relations. Clinically, the patients presented with cyanosis when pulmonary stenosis was present and with congestive cardiacfailure when pulmonary stenosis was absent. http://heart.bmj.com/ The electrocardiogram is helpful in suggesting the presence of inverted or noninverted ventricles.
    [Show full text]
  • Tricuspid Stenosis and Regurgitation: Successful Treatment by Valve Transplantation
    120 Annals ofthe Rheumatic Diseases 1992; 51: 120-122 lupus erythematosus complicated by Systemic Ann Rheum Dis: first published as 10.1136/ard.51.1.120 on 1 January 1992. Downloaded from tricuspid stenosis and regurgitation: successful treatment by valve transplantation Diane E Ames, Ronald A Asherson, John D Coltart, Vassilios Vassilikos, J K Lloyd Jones, Graham R V Hughes Abstract arthralgias, she remained generally well until Clinical tricuspid stenosis has not previously September 1988, when she had a 'flare' of SLE; been reported in patients with systemic lupus she had, meanwhile, also developed Raynaud's erythematosus (SLE). A 25 year old woman phenomenon. Treatment with azathioprine was with active SLE presented with signs of begun at this time. severe right ventricular failure. Cardiac In March 1989 the patient had a further acute catheterisation confirmed the diagnosis of psychotic episode and recurrent pleuritic pains tricuspid stenosis and regurgitation together and polyarthralgias. On admission to hospital with mitral regurgitation. This patient under- she refused to have a physical examination. She went successful tricuspid and mitral valve was again treated with tranquillisers, and pulsed replacement. methylprednisolone and cyclophosphamide were given intravenously. By August 1989 she had received 13 pulses of cyclophosphamide It is well established from necropsy studies that without clinical improvement. This treatment cardiac manifestations of systemic lupus ery- was discontinued because she developed a thematosus (SLE) may involve the endo- severe thrombocytopenia (20x 109/1). At the cardium, myocardium, pericardium, heart same time, ankle oedema and abdominal swell- valves, and coronary vessels.' The endocardial ing, which had not been noted previously, were involvement described by Libman and Sacks2 seen.
    [Show full text]
  • Tricuspid and Pulmonic Valve Pathology
    Current Cardiology Reports (2019) 21: 54 https://doi.org/10.1007/s11886-019-1143-7 STRUCTURAL HEART DISEASE (RJ SIEGEL AND NC WUNDERLICH, SECTION EDITORS) Tricuspid and Pulmonic Valve Pathology Gregory A. Fishbein1 & Michael C. Fishbein1 Published online: 18 May 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Purpose of Review This review describes the normal structure and pathologic changes that affect the right-sided cardiac valves and chambers. Recent Findings The anatomy and pathology described have been known for many years. Knowledge of these findings has gained relevance. The pattern of endocarditis is changing. New diagnostic techniques have allowed better characterization of lesions responsible for cardiac dysfunction. Novel, less invasive interventions have made recognition of abnormalities more clinically relevant. Summary There are many different pathologic entities that can affect the right-sided cardiac valves. These are discussed in this review. Keywords Tricuspid valve . Pulmonic valve . Carcinoid valve disease . Regurgitation . Stenosis . Intravenous drug use . Endocarditis . Congenital heart disease Introduction valves of the right side of the heart. Other causes of valvular disease, such as post-inflammatory (rheumatic) valvular dis- Right-sided valvular heart disease, that is, pathology affecting ease, drug-induced valve disease, and radiation-induced inju- the tricuspid and/or pulmonic valves, is less common than ry, while more likely to affect the left side of the heart, may disease affecting the left-sided heart valves. However, there concomitantly occur with right-sided involvement. are certain situations in which right-sided valvular disease is more prevalent. The etiology of right-sided valvular dysfunc- tion may be primary or secondary, congenital or acquired, or iatrogenic or natural.
    [Show full text]
  • His Bundle Pacing in Ebstein's Anomaly
    EP CASE REPORT ....................................................................................................................................................... His bundle pacing in Ebstein’s anomaly Louise Segan*, Mark Perrin, Jessica Thomas, and Daryl Ridley Department of Cardiology, Barwon Health, Ryrie Street, Geelong VIC 3220, Australia * Corresponding author. Tel: +613 4215 0000; fax: +613 4215 1990. E-mail address: [email protected] Introduction Ebstein’s anomaly is characterized by infe- rior displacement of the tricuspid valve, creating a portion of ‘atrialized’ right ven- tricle and progressive right heart enlarge- ment. Atrial arrhyth- mias are common; however, permanent pacing is infrequently required.1,2 This is the first documented case demonstrating feasibil- ity of His bundle pac- ing in Ebstein’s anomaly. Clinical case A 41-year-old male had recurrent, diffi- cult-to-control paro- xysmal atrial flutter in the context of Ebs tein’s anomaly and pre vious surgical Wolff– Parkinson–White abl ation during child- hood. Despite two catheter ablation at Figure 1 Panel A, top image: programmer interrogation demonstrating his spike (red arrow); bottom image: elec- tempts and multiple trogram (EGM) demonstrating non-selective His to RV septal capture (bottom left; His capture-red arrow; RV septal cardioversions, he had capture-blue arrow) with significant change in ventriculoatrial conduction from His bundle to RV pacing (bottom ongoing symptomatic right arrows, respectively). episodes of atrial flut- ter resulting in fre- quent hospital presentations. Echocardiography demonstrated severe right atrial (RA) enlargement (RA area 38 cm2), right ventricular (RV) dilatation with associated RV dysfunction and severe tricuspid regurgitation. The left ventricular (LV) function was preserved. A decision was made to offer perma- nent pacemaker implantation and staged atrioventricular (AV) node ablation as a definitive treatment strategy.
    [Show full text]