where does the pulmonary circuit of the heart begin
the lungs
2981476
Human knowledge of pulmonary circulation grew gradually over centuries, and scientists Ibn al-Nafis, Michael Servetus, and William Harvey provided some of the first accurate descriptions of this process. Deoxygenated blood leaves the heart, goes to the lungs, and then re-enters the heart; Deoxygenated blood leaves through the right ventricle through the pulmonary artery. From the right atrium, the blood is pumped through the tricuspid valve (or right atrioventricular valve), into the right ventricle. Blood is then pumped from the right ventricle through the pulmonary valve and into the main pulmonary artery. The pulmonary arteries carry deoxygenated blood to the lungs,
Pulmonary circulation
14451052
collects oxygen from the lungs and delivers carbon dioxide for exhalation. The systemic circuit transports oxygen to the body and returns relatively de-oxygenated blood and carbon dioxide to the pulmonary circuit. Blood flows through the heart in one direction, from the atria to the ventricles, and out through the pulmonary artery into the pulmonary circulation, and the aorta into the systemic circulation. The pulmonary artery (also trunk) branches into the left and right pulmonary arteries to supply each lung. Blood is prevented from flowing backwards (regurgitation) by the tricuspid, bicuspid, aortic, and pulmonary valves. The function of the "right heart",
Cardiac physiology
2121150
blood travelled from the heart to the lungs where it was mixed with air and then returned to the heart. The permeability of the septum was questioned by Michael Servetus in "Christianismi Restitutio" in 1553 and by Ibn al-Nafis in the 13th century and both proposed that the blood was pushed from the right ventricle to the left via the lungs, however, both of these accounts were largely forgotten. Colombo was the first to propose the pulmonary circuit in an intellectual climate that could expand on his theory. In addition to the pulmonary circuit, Colombo also discovered that the main
Realdo Colombo
3160938
heart drops as the lungs open and begin working, causing the foramen ovale to close entirely. In about 25% of adults, the foramen ovale does not entirely seal. In these cases, any elevation of the pressure in the pulmonary circulatory system (due to pulmonary hypertension, temporarily while coughing, etc.) can cause the foramen ovale to remain open. Due to the communication between the atria that occurs in ASDs, disease entities or complications from the condition are possible. Patients with an uncorrected atrial septal defect may be at increased risk for developing a cardiac arrhythmia, as well as more frequent respiratory
Atrial septal defect
67233
circulation — through the lungs — called the pulmonary circulation — and then back out to the body. This means that the heart is connected to and affects the entirety of the body. Simplified, the heart is a circuit of the Circulation. While plenty is known about the healthy heart, the bulk of study in cardiology is in disorders of the heart and restoration, and where possible, of function. The heart is a muscle that squeezes blood and functions like a pump. Each part of the heart is susceptible to failure or dysfunction and the heart can be divided into
Cardiology
20524991
into the tissue. This results in edema (fluid build-up) in the tissues. In right-sided heart failure, this commonly starts in the ankles where venous pressure is high due to the effects of gravity (although if the patient is bed-ridden, fluid accumulation may begin in the sacral region.) It may also occur in the abdominal cavity, where the fluid buildup is called ascites. In left-sided heart failure edema can occur in the lungs – this is called cardiogenic pulmonary edema. This reduces spare capacity for ventilation, causes stiffening of the lungs and reduces the efficiency of gas exchange by increasing the
Pathophysiology of heart failure
2981484
blood to the lungs. He also proposed two atria of the heart that functioned to capture air. Hippocrates was one of the first to begin to accurately describe the anatomy of the heart and to describe the involvement of the lungs in circulation, but his descriptions of the process of pulmonary circulation and of the functions of the parts of the heart were still largely incorrect. Greek philosopher and scientist Aristotle (384 - 322 BCE) followed Hippocrates and proposed that the heart had three ventricles, rather than two, that all connected to the lungs. The Greek physician Erasistratus (315 -
Pulmonary circulation
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Pulmonary artery banding Pulmonary Artery Banding (PAB) was introduced by Muller and Danimann in 1951 as a surgical technique to reduce excessive pulmonary blood flow in infants suffering from congenital heart defects. PAB is a palliative operation as it does not correct the problems, but attempts to improve abnormal heart function, relieve symptoms and reduce high pressure in the lungs. The use of PAB has decreased over the years due to advancements in definitive surgical repairs, however PAB still has widespread clinical use. PAB is commonly used in patients when definitive surgical repair is not feasible. The technique was first
Pulmonary artery banding
19835112
veins before reaching the right heart. Thus completing the cycle of blood going to heart and then coming from it and going to all parts of the body. The tricuspid valve, right heart (right ventricle), pulmonary valve, pulmonary artery, lungs, pulmonary veins and right heart are the elements of the Pulmonary Circulation System. The process of gas exchange, that is, exchange of carbon dioxide with oxygen in the lungs is the main function of the pulmonary system. The de-oxygenated blood from the right ventricle is pumped to the lungs where the capillaries surrounding the alveole sacks exchange carbon dioxide for
Biofluid dynamics
20784504
Medical Center. By 1989, he had performed around 500 heart transplants and more than 50 heart-lung transplants. However, due to the shortage of donor supplies, an attempt was made to reduce heart-lung transplants. The heart was increasingly repaired where possible and pulmonary thromboendarterectomy (PTE) performed for Chronic thromboembolic pulmonary hypertension (CTEPH). PTE is an operation that removes old blood clots from the pulmonary arteries in the lungs of people whose long-term clots have caused pulmonary hypertension or CTEPH. Many physicians have been unaware of the existence of CTEPH and as a consequence it has been underdiagnosed. Jamieson was the first
Stuart W. Jamieson
18145942
Pulmonary venoocclusive disease Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension caused by progressive blockage of the small veins in the lungs. The blockage leads to high blood pressures in the arteries of the lungs, which, in turn, leads to heart failure. The disease is progressive and fatal, with median survival of about 2 years from the time of diagnosis to death. The definitive therapy is lung transplantation. The symptoms for pulmonary veno-occlusive disease are the following: <br> The genetic cause of pulmonary veno-occlusive disease is mutations in EIF2AK4 gene. Though this does not mean other possible
Pulmonary venoocclusive disease
5612777
apnea. Another example of preliminary treatment is heart catheterization to evaluate the defect or defects of the heart; this procedure is much more invasive. Ultimately, however, the individual will need to have a series of surgeries to improve the blood flow permanently. The first surgery will likely be performed shortly after birth. A shunt can be created between the aorta and the pulmonary artery to help increase blood flow to the lungs. As the child grows, so does the heart and the shunt may need to be revised in order to meet the body's requirements. The type of surgery recommended
Pulmonary atresia
5612773
Pulmonary atresia Pulmonary atresia is a congenital malformation of the pulmonary valve in which the valve orifice fails to develop. The valve is completely closed thereby obstructing the outflow of blood from the heart to the lungs. The pulmonary valve is located on the right side of the heart between the right ventricle and pulmonary artery. In a normal functioning heart, the opening to the pulmonary valve has three flaps that open and close In congenital heart defects such as pulmonary atresia, structural abnormalities can include the valves of the heart, and the walls and arteries/veins near the heart muscle.
Pulmonary atresia
4994613
in the right ventricle, leading to lower oxygenation saturation. In addition, both the Blalock-Taussig and the Sano shunts expose the lungs to systemic arterial pressures, leading to long-term pulmonary hypertension and eventually heart failure. The Hybrid procedure may be used in place of the Norwood. The Hybrid procedure does not necessitate the use of heart-lung bypass or performing a sternotomy. Instead of a six-hour surgery, the Hybrid typically takes one to two hours. In this procedure, a stent is placed in the ductus arteriosus to maintain its patency, and bands are placed over both the left and right pulmonary artery
Hypoplastic left heart syndrome
5903794
there are holes in the septum that divide the four chambers of the heart the oxygen-rich blood and oxygen-poor blood mix this creates more stress on the heart to pump blood to where oxygen is needed. As a result, you get enlargement of the heart, heart failure (being unable to adequately supply body with needed oxygen, pulmonary hypertension, and pneumonia. The development of pulmonary hypertension is very serious. And this because the left ventricle is weakened due to its overuse. When this happens, the pressure backs up into the pulmonary veins and the lungs. This type of damage is irreversible
Atrioventricular septal defect
8057511
General ECG features include: Specific ECG features (assumes normal calibration of 1 mV = 10 mm): Other chest lead criteria: ST segment depression and T wave inversion in right precordial leads is usually seen in severe RVH such as in pulmonary stenosis and pulmonary hypertension. https://www.medicalnewstoday.com/articles/318959.php Right ventricular hypertrophy Right ventricular hypertrophy (RVH) is a form of ventricular hypertrophy affecting the right ventricle. Blood travels through the right ventricle to the lungs via the pulmonary arteries. If conditions occur which decrease pulmonary circulation, meaning blood does not flow well from the heart to the lungs, extra stress can be placed
Right ventricular hypertrophy
472789
away from the heart to the tissues, except for pulmonary arteries, which carry blood to the lungs for oxygenation (usually veins carry deoxygenated blood to the heart but the pulmonary veins carry oxygenated blood as well). There are two types of unique arteries. The pulmonary artery carries blood from the heart to the lungs, where it receives oxygen. It is unique because the blood in it is not "oxygenated", as it has not yet passed through the lungs. The other unique artery is the umbilical artery, which carries deoxygenated blood from a fetus to its mother. Arteries have a blood
Artery
2981477
where carbon dioxide is released and oxygen is picked up during respiration. Arteries are further divided into very fine capillaries which are extremely thin-walled. The pulmonary vein returns oxygenated blood to the left atrium of the heart. The oxygenated blood then leaves the lungs through pulmonary veins, which return it to the left heart, completing the pulmonary cycle. This blood then enters the left atrium, which pumps it through the mitral valve into the left ventricle. From the left ventricle, the blood passes through the aortic valve to the aorta. The blood is then distributed to the body through the
Pulmonary circulation
12894472
Anomalous pulmonary venous connection Anomalous pulmonary venous connection (or anomalous pulmonary venous drainage or anomalous pulmonary venous return) is a congenital defect of the pulmonary veins. "Total anomalous pulmonary venous connection", also known as total "anomalous pulmonary venous return", is a rare cyanotic congenital heart defect in which all four pulmonary veins are malpositioned and make anomalous connections to the systemic venous circulation. (Normally, pulmonary veins return oxygenated blood from the lungs to the left atrium where it can then be pumped to the rest of the body). A patent foramen ovale, patent ductus arteriosus or an atrial septal defect
Anomalous pulmonary venous connection
2304300
(in length) of the ventricle in response to acute increased pressure. To be classified as pulmonary heart disease, the cause must originate in the pulmonary circulation system. Two causes are vascular changes as a result of tissue damage (e.g. disease, hypoxic injury), and chronic hypoxic pulmonary vasoconstriction. If left untreated, then death may result, RVH due to a systemic defect is not classified as pulmonary heart disease. The heart and lungs are intricately related; whenever the heart is affected by a disease, the lungs risk following and vice versa. The symptoms/signs of pulmonary heart disease (cor pulmonale) can be non-specific
Pulmonary heart disease
1578647
remained hidden for decades. In passage V, Servetus recounts his discovery that the blood of the pulmonary circulation flows from the heart to the lungs (rather than air in the lungs flowing to the heart as had been thought). His discovery was based on the colour of the blood, the size and location of the different ventricles, and the fact that the pulmonary vein was extremely large, which suggested that it performed intensive and transcendent exchange. However, Servetus does not only deal with cardiology. In the same passage, from page 169 to 178, he also refers to the brain, the
Michael Servetus
639686
the left chamber but there is no direct pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart and there form the vital spirit..." In addition, Ibn al-Nafis had an insight into what would become a larger theory of the capillary
Vein
677637
pathway between them. The thick septum of the heart is not perforated and does not have visible pores as some people thought or invisible pores as Galen thought. The blood from the right chamber must flow through the vena arteriosa (pulmonary artery) to the lungs, spread through its substances, be mingled there with air, pass through the arteria venosa (pulmonary vein) to reach the left chamber of the heart and there form the vital spirit..." In addition, Ibn al-Nafis had an insight into what would become a larger theory of the capillary circulation. He stated that "there must be small
Circulatory system
11173362
septectomy was developed by Vivien Thomas in a canine model and performed in humans by Alfred Blalock. There are two types of this procedure: balloon atrial septostomy (also called endovascular atrial septostomy, Rashkind atrial balloon septostomy, or simply Rashkind's procedure) and blade atrial septostomy (also called static balloon atrial septostomy). In a normal heart, oxygen-depleted blood ("blue") is pumped from the right side of the heart, through the pulmonary artery, to the lungs where it is oxygenated. This is the pulmonary circulation part of blood flow. The oxygen-rich ("red") blood then returns to the left heart, via the pulmonary veins,
Atrial septostomy
7823573
known as ventricular hypertrophy leading to eventual heart failure. Patent ductus arteriosus also appears in the breed. It is a condition where a small blood vessel connecting two major arteries does not close following birth. It can cause complications as it is positioned to allow the blood flow to bypass the lungs. It also appears in American Staffordshire Terriers. A heart condition uncommon to the breed is tetralogy of Fallot, which is more common in the Keeshond and English Bulldog breeds relatively. It is actually a combination of up to four conditions, including the previously mentioned pulmonary valve stenosis, with
Sussex Spaniel
2304304
of single/double lung in extreme cases of cor pulmonale is also an option. The epidemiology of pulmonary heart disease (cor pulmonale) accounts for 7% of all heart disease in the U.S. According to Weitzenblum, et al., the mortality that is related to cor pulmonale is not easy to ascertain, as it is a complication of COPD. Pulmonary heart disease Pulmonary heart disease, also known as cor pulmonale, is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs. Chronic pulmonary
Pulmonary heart disease
2304299
Pulmonary heart disease Pulmonary heart disease, also known as cor pulmonale, is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs. Chronic pulmonary heart disease usually results in right ventricular hypertrophy (RVH), whereas acute pulmonary heart disease usually results in dilatation. Hypertrophy is an adaptive response to a long-term increase in pressure. Individual muscle cells grow larger (in thickness) and change to drive the increased contractile force required to move the blood against greater resistance. Dilatation is a stretching
Pulmonary heart disease
3909939
both gram-positive and gram-negative bacteria. Right-atrial and left-atrial isomerism and associated pulmonary issues are treated in a series of steps based on the severity of symptoms. Isomeric patients are first treated by inserting a shunt that will move incoming blood through the pulmonary circuit. The Fontan procedure routes blood through the patient's single ventricle, to the lungs, and into systemic circulation. This process is favorable in patients aged 2 to 5 years old. About 20-30% of patients will require a heart transplant. Left-atrial isomeric patients have less severe complications, as they typically have 2 functional ventricles. In this case, they
Situs ambiguus
5612780
of life. Many children with pulmonary atresia will go on to lead normal lives, though complications such as endocarditis, stroke and seizures are possible. Pulmonary atresia Pulmonary atresia is a congenital malformation of the pulmonary valve in which the valve orifice fails to develop. The valve is completely closed thereby obstructing the outflow of blood from the heart to the lungs. The pulmonary valve is located on the right side of the heart between the right ventricle and pulmonary artery. In a normal functioning heart, the opening to the pulmonary valve has three flaps that open and close In congenital
Pulmonary atresia
5803621
to allow access to the lungs CXR : decreased pulmonary blood flow and oligemic lung field ECG : left axis deviation Tricuspid atresia Tricuspid atresia is a form of congenital heart disease whereby there is a complete absence of the tricuspid valve. Therefore, there is an absence of right atrioventricular connection. This leads to a hypoplastic (undersized) or absent right ventricle. This defect is contracted during prenatal development, when the heart does not finish developing. It causes the heart to be unable to properly oxygenate the rest of the blood in the body. Because of this, the body does not
Tricuspid atresia
9578607
consideration results in de-oxygenated blood going to the heart from the lungs via the pulmonary veins. If giving pure oxygen at 100% for five-ten minutes doesn't raise the arterial pressure of O2 more than it does the alveolar pressure of O2 then the defect in the lung is because of a pulmonary shunt. This is because although the PO2 of alveolar gas has been changed by giving pure supplemental O2, the PaO2 (arterial gas pressure) will not increase that much because the V/Q mismatch still exists and it will still add some de-oxygenated blood to the arterial system via the
Pulmonary shunt
2763028
Pulmonary artery A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the "main pulmonary artery." or "pulmonary trunk" from the heart, and the smallest ones are the arterioles, which lead to the capillaries that surround the pulmonary alveoli. In order of blood flow, the pulmonary arteries start as the pulmonary trunk or main pulmonary artery. The main pulmonary artery begins at the base of the right ventricle. It is short and wide—approximately in length and in diameter. The main pulmonary
Pulmonary artery
639667
venules, which continue to converge and form the larger veins. The de-oxygenated blood is taken by veins to the right atrium of the heart, which transfers the blood to the right ventricle, where it is then pumped through the pulmonary arteries to the lungs. In pulmonary circulation the pulmonary veins return oxygenated blood from the lungs to the left atrium, which empties into the left ventricle, completing the cycle of blood circulation. The return of blood to the heart is assisted by the action of the muscle pump, and by the thoracic pump action of breathing during respiration. Standing or
Vein
1819092
portion of the partially oxygenated blood leaving the heart for the body into the lungs, increasing flow through the pulmonary circuit, and greatly relieving symptoms in patients. The first Blalock-Thomas-Taussig shunt surgery was performed on 15-month-old Eileen Saxon on November 29, 1944 with dramatic results. The Potts shunt and the Waterston-Cooley shunt are other shunt procedures which were developed for the same purpose. These are no longer used. Currently, Blalock-Thomas-Taussig shunts are not normally performed on infants with TOF except for severe variants such as TOF with pulmonary atresia (pseudotruncus arteriosus). The Blalock-Thomas-Taussig procedure, initially the only surgical treatment available
Tetralogy of Fallot
11716019
a closed, rebreathing circuit. This technique is based on the assumptions that a known volume and concentration of helium in air begin in the closed spirometer, that the patient has no helium in their lungs, and that an equilibration of helium can occur between the spirometer and the lungs. The nitrogen washout technique uses a non-rebreathing open circuit. The technique is based on the assumptions that the nitrogen concentration in the lungs is 78% and in equilibrium with the atmosphere, that the patient inhales 100% oxygen and that the oxygen replaces all of the nitrogen in the lungs. The plethysmography
Pulmonary function testing
2763035
after a period of immobility. A pulmonary embolus is a common cause of death in patients with cancer and stroke. A large pulmonary embolus which becomes lodged in the bifurcation of the pulmonary trunk with extensions into both the left and right main pulmonary arteries is called a "saddle embolus". Pulmonary artery A pulmonary artery is an artery in the pulmonary circulation that carries deoxygenated blood from the right side of the heart to the lungs. The largest pulmonary artery is the "main pulmonary artery." or "pulmonary trunk" from the heart, and the smallest ones are the arterioles, which lead
Pulmonary artery
2992577
drain into the pulmonary circulation in whole or in part, this is known as a total anomalous pulmonary venous connection (or drainage), or partial anomalous pulmonary connection, respectively. Pulmonary vein The pulmonary veins are the veins that transfer oxygenated blood from the lungs to the heart. The largest pulmonary veins are the four "main pulmonary veins", two from each lung that drain into the left atrium of the heart. The pulmonary veins are part of the pulmonary circulation. Two main pulmonary veins emerge from each lung hilum, receiving blood from three or four bronchial veins apiece and draining into the
Pulmonary vein
6528042
Pulmonary valve stenosis Pulmonary valve stenosis (PVS) is a heart valve disorder in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. This type of pulmonic stenosis results in the reduction of flow of blood to the lungs. Valvular pulmonic stenosis accounts for 80% of right ventricular outflow tract obstruction. While the most common cause of pulmonary valve stenosis is congenital heart disease, it may also be due to a malignant carcinoid tumor. Both stenosis of the pulmonary artery and pulmonary valve stenosis are forms of pulmonic stenosis (nonvalvular
Pulmonary valve stenosis
20277299
Chronic thromboembolic pulmonary hypertension Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term disease caused by a blockage in the blood vessels that deliver blood from the heart to the lungs (pulmonary arteries), resulting in increased pressure in these arteries (pulmonary hypertension). The blockage either results from a hardened blood clot that is thought to originate from the deep veins of the body (thromboembolism) and remains in the arteries, or from a scar that forms at the site where the clot has damaged the arteries, causing permanent fibrous obstruction (blood flow blockage). Most patients have a combination of microvascular (small vessel)
Chronic thromboembolic pulmonary hypertension
2981475
Pulmonary circulation The pulmonary circulation is the portion of the circulatory system which carries deoxygenated blood away from the right ventricle of the heart, to the lungs, and returns oxygenated blood to the left atrium and ventricle of the heart. The term pulmonary circulation is readily paired and contrasted with the systemic circulation. The vessels of the pulmonary circulation are the pulmonary arteries and the pulmonary veins. A separate system known as the bronchial circulation supplies oxygenated blood to the tissue of the larger airways of the lung. The earliest human discussions of pulmonary circulation date back to Egyptian times.
Pulmonary circulation
2992574
Pulmonary vein The pulmonary veins are the veins that transfer oxygenated blood from the lungs to the heart. The largest pulmonary veins are the four "main pulmonary veins", two from each lung that drain into the left atrium of the heart. The pulmonary veins are part of the pulmonary circulation. Two main pulmonary veins emerge from each lung hilum, receiving blood from three or four bronchial veins apiece and draining into the left atrium. An inferior and superior main vein drains each lung, so there are four main veins in total. At the root of the lung, the right superior
Pulmonary vein
6528046
cases, in broad terms PVS is rare in the general population. Pulmonary valve stenosis Pulmonary valve stenosis (PVS) is a heart valve disorder in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. This type of pulmonic stenosis results in the reduction of flow of blood to the lungs. Valvular pulmonic stenosis accounts for 80% of right ventricular outflow tract obstruction. While the most common cause of pulmonary valve stenosis is congenital heart disease, it may also be due to a malignant carcinoid tumor. Both stenosis of the pulmonary
Pulmonary valve stenosis
15368720
requires transplantation of an organ or organs, especially if complications develop. End-stage renal disease (stages 5 and 6; either acute and non-reversible, or chronic), severe congestive or other heart failure or certain congenital cardiac structural defects (where the blood cannot be oxygenated or backflows, or where the ejection fraction or distribution of blood is insufficient); and advanced chronic obstructive pulmonary disease, cystic fibrosis (when the lungs are no longer able to function), or emphysema, are possible indicators for, respectively, renal (kidney), cardiac (heart), or pulmonary (lung) transplantation. There are distinct parameters for who is eligible for transplantation of the different
Transplant surgeon
2981486
of his theories, like those of his predecessors, were incorrect, his theory of pulmonary circulation dominated the medical community for hundreds of years after his death. Galen contradicted Erasistratus before him by proposing that arteries carried both air and blood, rather than air alone. He proposed that the liver was the point of origin for all blood vessels and that the heart was not a pumping muscle, but rather an organ which blood passed through. Galen's theory included a new description of pulmonary circulation. In it, air was inhaled into the lungs where it became the pneuma. Pulmonary veins transmitted
Pulmonary circulation
14451053
is to collect de-oxygenated blood, in the right atrium, from the body via the superior vena cava, inferior vena cava and from the coronary sinus and pump it, through the tricuspid valve, via the right ventricle, through the semilunar pulmonary valve and into the pulmonary artery in the pulmonary circulation where carbon dioxide can be exchanged for oxygen in the lungs. This happens through the passive process of diffusion. In the "left heart" oxygenated blood is returned to the left atrium via the pulmonary vein. It is then pumped into the left ventricle through the bicuspid valve and into the
Cardiac physiology
3099249
however, TGA is a more general term which may also refer to levo-transposition of the great arteries (l-TGA). Another term commonly used to refer to both d-TGA and l-TGA is transposition of the great vessels (TGV), although this term might have an even broader meaning than TGA. In a normal heart, oxygen-depleted ("blue") blood is pumped from the right side of the heart, through the pulmonary artery, to the lungs where it is oxygenated. The oxygen-rich ("red") blood then returns to the left heart, via the pulmonary veins, and is pumped through the aorta to the rest of the body,
Dextro-Transposition of the great arteries
8057510
Right ventricular hypertrophy Right ventricular hypertrophy (RVH) is a form of ventricular hypertrophy affecting the right ventricle. Blood travels through the right ventricle to the lungs via the pulmonary arteries. If conditions occur which decrease pulmonary circulation, meaning blood does not flow well from the heart to the lungs, extra stress can be placed on the right ventricle. This can lead to right ventricular hypertrophy. It can affect electrocardiography (ECG) findings. An ECG with right ventricular hypertrophy may or may not show a right axis deviation on the graph. There are various symptoms that can be seen: Common causes include:
Right ventricular hypertrophy
2121149
the fact that the brain is the source of sense and motion. Colombo made several important advances in anatomy, including the discovery of the pulmonary circuit which paved the way for William Harvey's discovery of circulation years later. In the Galenic tradition, blood passed between the ventricles of the heart through micropores in the heart's septum and venous blood became arterial blood in the left ventricle of the heart where air was supplied by the pulmonary vein. During vivisections of dogs and other animals, Colombo repeatedly found only blood, and no air, in the pulmonary vein. In his model, venous
Realdo Colombo
6596792
Norwood procedure The Norwood procedure is the first surgery of three staged heart surgeries to create a new functional systemic circuit in patients with hypoplastic left heart syndrome or other complex heart defects with single ventricle physiology. The Norwood procedure (stage 1) involves atrial septectomy and transection and ligation of the distal main pulmonary artery. The proximal pulmonary artery is then connected to the hypoplastic aortic arch, while the coarcted segment of the aorta is repaired. An aortopulmonary shunt is created to connect the aorta to the main pulmonary artery to provide pulmonary blood flow. The second surgery (Stage 2)
Norwood procedure
6528044
pulmonary hypertension. This however, does not mean the cause is always congenital. The left ventricle can be changed physically, these changes are a direct result of right ventricular hypertrophy. Once the obstruction is subdued, it (the left ventricle) can return to normal. The diagnosis of pulmonary valve stenosis can be achieved via echocardiogram, as well as a variety of other means among them are: ultrasound, in which images of the heart chambers in utero where the tricuspid valve has thickening (or due to Fallot's tetralogy, Noonan's syndrome, and other congenital defects) and in infancy auscultation of the heart can reveal
Pulmonary valve stenosis
301708
by large volumes of blood flow in times of activity, such as running, since air is pumped by the air sacs rather than the lung itself. As a result, the capillaries in the parabronchi have thinner walls, permitting more efficient gaseous exchange. In combination with separate pulmonary and systemic circulatory systems, it helps to reduce stress on the BGB. The common ostrich heart is a closed system, contractile chamber. It is composed of myogenic muscular tissue associated with heart contraction features. There is a double circulatory plan in place possessing both a pulmonary circuit and systemic circuit. The common ostrich’s
Common ostrich
9578596
Cardiac shunt A cardiac shunt is a pattern of blood flow in the heart that deviates from the normal circuit of the circulatory system. It may be described as right-left, left-right or bidirectional, or as systemic-to-pulmonary or pulmonary-to-systemic. The direction may be controlled by left and/or right heart pressure, a biological or artificial heart valve or both. The presence of a shunt may also affect left and/or right heart pressure either beneficially or detrimentally. The left and right sides of the heart are named from a dorsal view, i.e., looking at the heart from the back or from the perspective
Cardiac shunt
3016756
and pulmonary valves open—and now blood is ejected from the heart. Ejection causes pressure within the ventricles to fall, and, simultaneously, the atria begin to refill (atrial diastole). Finally, pressures within the ventricles fall below the back pressures in the trunks of the aorta and the pulmonary arteries, and the aortic and pulmonary valves close. The ventricles start to relax, the mitral and tricuspid valves begin to open, and the cycle begins again. In summary, when the ventricles are in systole and contracting, the atria are relaxed and collecting blood as 'return' flows. When, in late diastole, the ventricles become
Diastole
3170591
heart). The above equation contains a numerical constant to compensate for the units used, but is conceptually equivalent to the following: where R is the pulmonary vascular resistance (fluid resistance), ΔP is the pressure difference across the pulmonary circuit, and Q is the rate of blood flow through it. As an example: If Systolic pressure: 120 mmHg, Diastolic pressure: 80 mmHg, Right atrial mean pressure: 3 mmHg, Cardiac output: 5 l/min, Then Mean Arterial Pressure would be: (2 Diastolic pressure + Systolic pressure)/3 = 93.3 mmHg, and Systemic vascular resistance: (93 - 3) / 5 = 18 Wood Units. Or
Vascular resistance
5612779
is left uncorrected it may be fatal, but the prognosis has greatly improved over the years for those with pulmonary atresia. Some factors that affect how well the child does include how well the heart is beating, and the condition of the blood vessels that supply the heart. Most cases of pulmonary atresia can be helped with surgery, if the patient's right ventricle is exceptionally small, many surgeries will be needed in order to help stimulate normal circulation of blood to the heart.If uncorrected, babies with this type of congenital heart disease may only survive for the first few days
Pulmonary atresia
17280299
aorta is in the left and dorsal portion. The distal portion of the aorta is pushed forward to the right. The proximal pulmonary artery is right and ventral, and the distal portion of the pulmonary artery is in the left dorsal portion. The rhythmic electrical depolarization waves that trigger myocardial contraction is myogenic, which means that they begin in the heart muscle spontaneously and are then responsible for transmitting signals from cell to cell. Myocytes that were obtained in the primitive heart tube, start beating as they connect together by their walls in a syncytium. Myocytes initiate rhythmic electrical activity,
Heart development
11383944
Bidirectional Glenn procedure The bidirectional Glenn shunt or hemi-Fontan procedure is one of several surgical technique used to temporarily improve cardiac function in patients with severe structural heart disease which feature single ventricular physiology. Patients with certain severe valvular or ventricular anomalies (e.g. hypoplastic left heart syndrome or single ventricle, etc.), have an abnormal cardiopulmonary circuit in which a single ventricle functionally serves as the driver of both systemic and pulmonary circulations. Typically, the bidirectional Glenn shunt is the second in a series of three staged surgeries to reconstruct a single ventricle heart, in situations where corrective bi-ventricular surgery or
Bidirectional Glenn procedure
3171077
was first identified by Ernst von Romberg in 1891. The symptoms of pulmonary hypertension include the following: Less common signs/symptoms include non-productive cough and exercise-induced nausea and vomiting. Coughing up of blood may occur in some patients, particularly those with specific subtypes of pulmonary hypertension such as heritable pulmonary arterial hypertension, Eisenmenger syndrome and chronic thromboembolic pulmonary hypertension. Pulmonary venous hypertension typically presents with shortness of breath while lying flat or sleeping (orthopnea or paroxysmal nocturnal dyspnea), while pulmonary arterial hypertension (PAH) typically does not. Other typical signs of pulmonary hypertension include an accentuated pulmonary component of the second heart
Pulmonary hypertension
3170590
the cardiac output is measured in units of litres per minute (L/min). The pulmonary artery wedge pressure (also called pulmonary artery occlusion pressure or PAOP) is a measurement in which one of the pulmonary arteries is occluded, and the pressure downstream from the occlusion is measured in order to approximately sample the left atrial pressure. Therefore, the numerator of the above equation is the pressure difference between the input to the pulmonary blood circuit (where the heart's right ventricle connects to the pulmonary trunk) and the output of the circuit (which is the input to the left atrium of the
Vascular resistance
19649607
Right heart strain Right heart strain (also right ventricular strain or RV strain) is a medical finding of right ventricular dysfunction where the heart muscle of the right ventricle (RV) is deformed. Right heart strain can be caused by pulmonary hypertension, pulmonary embolism (or PE, which itself can cause pulmonary hypertension), RV infarction (a heart attack affecting the RV), chronic lung disease, pulmonic stenosis, bronchospasm, and pneumothorax. When using an echocardiograph (echo) to visualize the heart, strain can appear with the RV being enlarged and more round than typical. When normal, the RV is about half the size of the
Right heart strain
8194194
hypertension, which, among other things, can lead to cor pulmonale, a condition that causes the right side of the heart to fail. The dysfunction of BMPR2 can also lead to an elevation in pulmonary arterial pressure due to an adverse response of the pulmonary circuit to injury. It is especially important to screen for BMPR2 mutations in relatives of patients with idiopathic pulmonary hypertension, for these mutations are present in >70% of familial cases. There have been studies which has correlated BMPR2 with exercise induced elevation of PA pressure by measuring tricuspid regurgitation velocity by echocardiography. BMPR2 Bone morphogenetic protein
BMPR2
6038936
blood flow in tissues, so oxygen distribution decreases. The vasoconstriction of the pulmonary arterioles is caused by hypoxia in the right portion of the heart. Arteriole spasms include the major part of the blood flow through the pulmonary vessels, producing a short circuit in the blood flow giving less oxygen in blood. The person will recover if there is an administration of oxygen or if s/he is taken to low altitudes. Mountaineering disease and pulmonary edema are most common in those who climb rapidly to a high altitude.This illness starts from a few hours up to two or three days
Aerospace physiology
11383946
by Dr. Azzolina in 1973. The original description by Dr. Glenn allowed communication only between the right pulmonary artery and the SVC, whereas the modified technique had the SVC connecting at or before the bifurcation between the right and left pulmonary arteries. Bidirectional Glenn procedure The bidirectional Glenn shunt or hemi-Fontan procedure is one of several surgical technique used to temporarily improve cardiac function in patients with severe structural heart disease which feature single ventricular physiology. Patients with certain severe valvular or ventricular anomalies (e.g. hypoplastic left heart syndrome or single ventricle, etc.), have an abnormal cardiopulmonary circuit in which
Bidirectional Glenn procedure
12883871
is generally specific to the individual patient, with the objective of meeting the needs of the patient. It is a broad program and may benefit patients with lung diseases such as chronic obstructive pulmonary disease (COPD), sarcoidosis, idiopathic pulmonary fibrosis (IPF) and cystic fibrosis, among others. Although the process is focused on the rehabilitation of the patient him/herself, the family is also involved. The process typically does not begin until a medical exam of the patient has been performed by a licensed physician. The setting of pulmonary rehabilitation varies by patient; settings may include inpatient care, outpatient care, the office
Pulmonary rehabilitation
1830492
which is fused to and inseparable from the fibrous pericardium, and the "visceral pericardium", which is part of, or in some textbooks synonymous with, the epicardium. Both of these layers function in lubricating the heart to prevent friction during heart activity. The visceral layer extends to the beginning of the great vessels (the large blood vessels serving the heart) becoming one with the parietal layer of the serous pericardium. This happens at two areas: where the aorta and pulmonary trunk leave the heart and where the superior vena cava, inferior vena cava and pulmonary veins enter the heart. In between
Pericardium
3709522
are usually of the form codice_2 where "codice_3" is the name of a circuit and "codice_4" is an XML-defined "method" within that circuit known as a fuseaction. The query-string variable name "fuseaction" can vary depending on configuration parameters, so not all applications using Fusebox need to use the action variable "fuseaction". Fusebox encourages, but does not enforce, separation of presentation logic from business logic. It uses a number of file naming conventions to encourage this separation: presentation files begin with dsp (display) or lay (layout), database access files begin with qry (query) and general business files begin with act (action).
Fusebox (programming)
15724144
controlled weeks or even months after the operation. Reports also show that the recovery period in patients that obtained the FloWatch device was faster and smoother in comparison to those that received the traditional PAB method. However FloWatch is only suitable for children with a body weight ranging from 3 kg to10kg. Pulmonary artery banding Pulmonary Artery Banding (PAB) was introduced by Muller and Danimann in 1951 as a surgical technique to reduce excessive pulmonary blood flow in infants suffering from congenital heart defects. PAB is a palliative operation as it does not correct the problems, but attempts to improve
Pulmonary artery banding
3171080
for Heart and Lung Transplantation, and provide the current framework for understanding and treatment of pulmonary hypertension. According to WHO classification there are 5 groups of PH, where Group I (pulmonary arterial hypertension) is further subdivided into Group I<nowiki>' and Group I"</nowiki> classes. The most recent WHO classification system (with adaptations from the more recent ESC/ERS guidelines shown in italics) can be summarized as follows: WHO Group I – Pulmonary arterial hypertension (PAH) WHO Group I' – Pulmonary veno-occlusive disease (PVOD), pulmonary capillary hemangiomatosis (PCH) WHO Group I" – Persistent pulmonary hypertension of the newborn WHO Group II – Pulmonary
Pulmonary hypertension
5788362
will be placed on cardiopulmonary bypass to allow the surgeon to work on a still heart. The heart is opened and the ventricular septal defect is closed with a patch. The pulmonary arteries are then detached from the common artery (truncus arteriosus) and connected to the right ventricle using a tube (a conduit or tunnel). The common artery, now separated from the pulmonary circulation, functions as the aorta with the truncal valve operating as the aortic valve. Most babies survive this surgical repair, but may require further surgery as they grow up. For example, the conduit does not grow with
Persistent truncus arteriosus
12928876
with surgery. Stenosis of pulmonary artery Stenosis of the pulmonary artery is a condition where the pulmonary artery is subject to an abnormal constriction (or stenosis). Peripheral pulmonary artery stenosis may occur as an isolated event or in association with Alagille syndrome, Berardinelli-Seip congenital lipodystrophy type 1, Costello syndrome, Keutel syndrome, nasodigitoacoustic syndrome (Keipert syndrome), Noonan syndrome or Williams syndrome. It should not be confused with a pulmonary valve stenosis, which is in the heart, but can have similar hemodynamic effects. Both stenosis of the pulmonary artery and pulmonary valve stenosis are causes of pulmonic stenosis. In some cases it
Stenosis of pulmonary artery
12928875
Stenosis of pulmonary artery Stenosis of the pulmonary artery is a condition where the pulmonary artery is subject to an abnormal constriction (or stenosis). Peripheral pulmonary artery stenosis may occur as an isolated event or in association with Alagille syndrome, Berardinelli-Seip congenital lipodystrophy type 1, Costello syndrome, Keutel syndrome, nasodigitoacoustic syndrome (Keipert syndrome), Noonan syndrome or Williams syndrome. It should not be confused with a pulmonary valve stenosis, which is in the heart, but can have similar hemodynamic effects. Both stenosis of the pulmonary artery and pulmonary valve stenosis are causes of pulmonic stenosis. In some cases it is treated
Stenosis of pulmonary artery
9578603
lungs become consolidated. The shunt fraction is the percentage of blood put out by the heart that is not completely oxygenated. In pathological conditions such as pulmonary contusion, the shunt fraction is significantly greater and even breathing 100% oxygen does not fully oxygenate the blood. A small degree of shunt is normal and may be described as an 'anatomical shunt'. Anatomical shunting occurs when too much of the blood supplying the lung tissues via the bronchial arteries is returned via the pulmonary veins, bypassing the gas exchange. In addition, some of the smallest cardiac veins drain directly into the left
Pulmonary shunt
11870623
at the edges. Pulmonary laceration may not be visible using chest X-ray because an associated pulmonary contusion or hemorrhage may mask it. As the lung contusion clears (usually within two to four days), lacerations begin to become visible on chest X-ray. CT scanning is more sensitive and better at detecting pulmonary laceration than X-rays are, and often reveals multiple lacerations in cases where chest X-ray showed only a contusion. Before CT scanning was widely available, pulmonary laceration was considered unusual because it was not common to find with X-ray alone. On a CT scan, pulmonary lacerations show up in a
Pulmonary laceration
9578601
ASD; or prostaglandin can be administered to a newborn to prevent the ductus arteriosus from closing. Biological tissues may also be used to construct artificial passages. Mechanical shunts such as the Blalock-Taussig shunt are used in some cases of CHD to control blood flow or blood pressure. All reptiles have the capacity for cardiac shunts. Cardiac shunt A cardiac shunt is a pattern of blood flow in the heart that deviates from the normal circuit of the circulatory system. It may be described as right-left, left-right or bidirectional, or as systemic-to-pulmonary or pulmonary-to-systemic. The direction may be controlled by left
Cardiac shunt
2304301
and depend on the stage of the disorder, and can include blood backing up into the systemic venous system, including the hepatic vein. As pulmonary heart disease progresses, most individuals will develop symptoms like: The causes of pulmonary heart disease (cor pulmonale) are the following: The pathophysiology of pulmonary heart disease (cor pulmonale) has always indicated that an increase in right ventricular afterload causes RV failure (pulmonary vasoconstriction, anatomic disruption/pulmonary vascular bed and increased blood viscosity are usually involved ), however most of the time, the right ventricle adjusts to an overload in chronic pressure. According to Voelkel, et al.,
Pulmonary heart disease
3741988
CO ejected through a shunt is harmless; a high index or percentage of CO ejected through a left-to-right shunt heralds Eisenmenger's physiology. The left-to-right shunting of blood results in abnormally high blood flow and pressure directed to the right heart circulation, gradually leading to maladaptive changes that ultimately result in pulmonary hypertension. Increased right-sided blood volume and pressure causes a cascade of pathologic damage to the delicate pulmonary capillaries, causing them to be incrementally replaced with scar tissue. Scar (dead lung tissue) does not contribute to oxygen transfer, therefore decreasing the useful volume of the pulmonary vasculature. The scar tissue
Eisenmenger's syndrome
8442907
may be subject to compartmentalization (fire protection), this does not mean one no longer requires a rated box or wrap around the electrical outlet box or junction box where the wiring is terminated because that box may be disabled as a result of a fire within the room. The probability of electrical fires are a strong motivating factor for compartmetalisation to begin with. The cable may thus be operable but the circuit as a whole may be defeated because the junction box would not have been protected. Such omissions are not entirely uncommon in the field. Circuit integrity Circuit integrity
Circuit integrity
67225
these "blue babies." They eventually figured out how to do just that by the anastomosis of the systemic artery to the pulmonary artery and called this the Blalock-Taussig Shunt. Tetralogy of Fallot, pulmonary atresia, double outlet right ventricle, transposition of the great arteries, persistent truncus arteriosus, and Ebsteins anomaly are various congenital cyanotic heart diseases. Congenital cyanotic heart diseases is where something is wrong with the heart of a newborn and it is not oxygenating the blood efficiently. Tetralogy of Fallot is the most common congenital heart disease arising in 1–3 cases per 1,000 births. The cause of this defect
Cardiology
7602992
Coronary sulcus The atria of the heart are separated from the ventricles by the coronary sulcus (also called coronary groove, auriculoventricular groove, atrioventricular groove, AV groove). The structure contains the trunks of the nutrient vessels of the heart, and is deficient in front, where it is crossed by the root of the pulmonary trunk. On the posterior surface of the heart, the coronary sulcus contains the coronary sinus. There are two coronary sulci in the heart including left and right coronary sulci. The left coronary sulcus originates posterior to the pulmonary trunk, and travels inferiorly separating the left atrium and
Coronary sulcus
1783512
the pulmonary artery. At the end of ventricular systole, when the pressure in the right ventricle falls rapidly, the pressure in the pulmonary artery will close the pulmonary valve. The closure of the pulmonary valve contributes the P2 component of the second heart sound. The right heart is a low-pressure system, so the P2 component of the second heart sound is usually softer than the A2 component of the second heart sound. However, it is physiologically normal in some young people to hear both components separated during inhalation. In the developing heart, the valves between the atria and ventricles, the
Heart valve
3021966
sound (S2). The right heart is a low-pressure system, so the P2 component of the second heart sound is usually softer than the A2 component of the second heart sound. However, it is physiologically normal in some young people to hear both components separated during inhalation. Pulmonary valve The pulmonary valve (sometimes referred to as the pulmonic valve) is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above
Pulmonary valve
12272273
airway system. Consequently, a cardio-selective β1-blocker with limited effect on β2-receptor decreases the heart rate without the pulmonary adverse effects in patients with COPD or Asthma. Pharmacological stimulation of β2 receptors increases coronary blood flow in healthy humans and in patients with mildly atherosclerotic coronary arteries. Thus, not only does a cardio-selective β1-blocker reduce myocardial oxygen demand during exercise, but it also unveils β2-receptor-mediated coronary exercise hyperemia, while reducing the heart rate selectively. Interestingly, landiolol does not possess any sodium and calcium antagonistic properties, which makes it a more suitable cardio-selective β-blocker for patients with heart failure due to its
Landiolol
3171097
a sensitivity and specificity of 88% and 56%, respectively. Thus, Doppler echocardiography can suggest the presence of pulmonary hypertension, but right heart catherization (described below) remains the gold standard for diagnosis of PAH. Echocardiography can also help to detect congenital heart disease as a cause of pulmonary hypertension. If the echocardiogram is compatible with a diagnosis of pulmonary hypertension, common causes of pulmonary hypertension (left heart disease and lung disease) are considered and further tests are performed accordingly. These tests generally include electrocardiography (ECG), pulmonary function tests including lung diffusion capacity for carbon monoxide and arterial blood gas measurements, X-rays
Pulmonary hypertension
1851710
tend to progress to failure of both ventricles. For example, left ventricular failure allows pulmonary edema and pulmonary hypertension to occur, which increase stress on the right ventricle. Right ventricular failure is not as deleterious to the other side, but neither is it harmless. Heart failure may also occur in situations of "high output" (termed "high-output heart failure"), where the amount of blood pumped is more than typical and the heart is unable to keep up. This can occur in overload situations (blood or serum infusions), kidney diseases, chronic severe anemia, beriberi (vitamin B/thiamine deficiency), hyperthyroidism, cirrhosis, Paget's disease, multiple
Heart failure
4902230
FVC (forced vital capacity) are reduced so the FEV1/FVC ratio is normal or even increased in contrast to obstructive lung disease where this ratio is reduced. The values for residual volume and total lung capacity are generally decreased in restrictive lung disease. Pulmonary fibrosis creates scar tissue. The scarring is permanent once it has developed. Slowing the progression and prevention depends on the underlying cause: Hypoxia caused by pulmonary fibrosis can lead to pulmonary hypertension, which, in turn, can lead to heart failure of the right ventricle. Hypoxia can be prevented with oxygen supplementation. Pulmonary fibrosis may also result in
Pulmonary fibrosis
3171098
of the chest and high-resolution computed tomography (CT) scanning. If heart disease and lung disease have been excluded, a ventilation/perfusion scan is performed to rule out CTEPH. If unmatched perfusion defects are found, further evaluation by CT pulmonary angiography, right heart catheterization, and selective pulmonary angiography is performed. Signs of pulmonary hypertension on CT scan of the chest are: Although pulmonary arterial pressure (PAP) can be estimated on the basis of echocardiography, pressure measurements with a Swan-Ganz catheter inserted through the right side of the heart provide the most definite assessment.[42] Pulmonary hypertension is defined as a mean PAP of
Pulmonary hypertension
3021965
Pulmonary valve The pulmonary valve (sometimes referred to as the pulmonic valve) is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above the pressure in the pulmonary artery. At the end of ventricular systole, when the pressure in the right ventricle falls rapidly, the pressure in the pulmonary artery will close the pulmonary valve. The closure of the pulmonary valve contributes the P2 component of the second heart
Pulmonary valve
473054
role in cardiac conduction. It arises from the lower part of the interventricular septum and crosses the interior space of the right ventricle to connect with the inferior papillary muscle. The right ventricle tapers into the pulmonary trunk, into which it ejects blood when contracting. The pulmonary trunk branches into the left and right pulmonary arteries that carry the blood to each lung. The pulmonary valve lies between the right heart and the pulmonary trunk. The left heart has two chambers: the left atrium, and the left ventricle, separated by the mitral valve. The left atrium receives oxygenated blood back
Heart
1799114
the veins, where the clotting may cause a deep vein thrombosis (DVT). If the venous clots break off, these clots can travel through the right side of the heart to the lung where they block a pulmonary blood vessel and cause a pulmonary embolism. It is extremely rare for this disorder to cause the formation of clots in arteries that can lead to stroke or heart attack, though a "mini-stroke", known as a transient ischemic attack, is more common. Given that this disease displays incomplete dominance, those who are homozygous for the mutated allele are at a heightened risk for
Factor V Leiden
14972067
heart to the point where it cannot pump effectively. Rupture of the intraventricular septum (the muscle separating the left and right ventricles) causes a ventricular septal defect with shunting of blood through the defect from the left side of the heart to the right side of the heart, which can lead to right ventricular failure as well as pulmonary overcirculation. Rupture of the papillary muscle may also lead to acute mitral regurgitation and subsequent pulmonary edema and possibly even cardiogenic shock. Since the electrical characteristics of the infarcted tissue change (see pathophysiology section), arrhythmias are a frequent complication. The re-entry
Myocardial infarction complications
2951769
has been linked with the development of pulmonary hypertension (increased pressure over the pulmonary artery); this, in turn, leads to episodes of syncope (fainting), chest pain, and progressive breathlessness. Pulmonary hypertension eventually causes right ventricular heart failure, the symptoms of which are peripheral edema (fluid accumulation in the skin of the legs) and ascites (fluid accumulation in the abdominal cavity). They may be classified according to the means of hemolysis, being either intrinsic in cases where the cause is related to the red blood cell (RBC) itself, or extrinsic in cases where factors external to the RBC dominate. Intrinsic effects
Hemolytic anemia
2763034
the pulmonary artery, and may be defined as a mean pulmonary artery pressure of greater than 25mmHg. As can be measured on a CT scan, a diameter of more than 29 mm diameter is often used as a cut-off to indicate pulmonary hypertension. This may occur as a result of heart problems such as heart failure, lung or airway disease such as COPD or scleroderma, or thromboembolic disease such as pulmonary embolism or emboli seen in sickle cell anaemia. Pulmonary embolism refers to an embolus that lodges in the pulmonary circulation. This may arise from a deep venous thrombosis, especially
Pulmonary artery
1819589
and ventricular systole is about to begin. The time variable for the left systolic cycle is measured from (mitral) valve-open to valve-closed. Atrial fibrillation represents a common electrical malady in the heart that appears during the time interval of atrial systole (see figure at right margin). Theory suggests that an ectopic focus, usually situated within the pulmonary trunks, competes with the sinoatrial node for electrical control of the atrial chambers and thereby diminishes the performance of the atrial myocardium, or atrial heart muscle. The ordered, sinoatrial control of atrial electrical activity is disrupted, causing the loss of coordinated generation of
Systole
20864352
LeCompte maneuver The LeCompte maneuver is a technique used in open heart surgery, primarily on infants and children. The maneuver entails cutting the main pulmonary artery and moving it anterior to the aorta before reattaching the pulmonary artery during the following reconstruction of the great vessels. It allows the surgeon to reconstruct the right ventricular outflow tract without needing to connect the proximal and distal sections with a graft. It also enables the surgeon to avoid compressing the coronary arteries and relieves compression of the bronchi in cases where the pulmonary artery is severely dilated or aneurysmal. If both pulmonary
LeCompte maneuver
6367608
inflammation of the pleura itself as can occur with infection, pulmonary embolus, tuberculosis, mesothelioma and other conditions. A pneumothorax is a hole in the pleura covering the lung allowing air in the lung to escape into the pleural cavity. The affected lung “collapses” like a deflated balloon. A tension pneumothorax is a particularly severe form of this condition where the air in the pleural cavity cannot escape, so the pneumothorax keeps getting bigger until it compresses the heart and blood vessels, leading to a life-threatening situation. Pulmonary vascular diseases are conditions that affect the pulmonary circulation. Examples are: Pulmonary diseases
Respiratory disease
13918030
liters per minute of fluid in normal operating range. The pump was designed to allow for temporary support of a dying heart. It is a continuous flow pump, it does not need to be synced to the rhythm of the heart. It assists in temporary heart stimulation with conditions such as cardiogenic shock following acute myocardial infarction, heart failure from cardio pulmonary bypass, and more. The pump can continually monitor the left ventricle, which allows for perpetual observation the hearts condition. This allows for any necessary changes to be made when needed. The pump operates at speeds between two hundred
Hemopump
12661956
as long as the ductus remains open: in such cases the closure of the ductus can be delayed by the administration of prostaglandins to permit sufficient time for the surgical correction of the anomalies. Conversely, in cases of patent ductus arteriosus, where the ductus does not properly close, drugs that inhibit prostaglandin synthesis can be used to encourage its closure, so that surgery can be avoided. Other heart birth defects include ventricular septal defect, pulmonary atresia, and tetralogy of Fallot. Fetal pain , its existence and its implications are debated politically and academically. According to the conclusions of a review
Fetus
19156973
procedure in the literature in the 1970s. At that time, the procedure was used for patients who had TGA with a ventricular septal defect (VSD). By the late 2000s, the procedure was employed in situations where the right ventricle is bigger than the left ventricle and the left ventricle connects to the pulmonary artery instead of the aorta; examples include double inlet left ventricle, TGA with tricuspid atresia and TGA with hypoplastic left heart syndrome. In the original DKS procedure, surgeons separated the main pulmonary artery (MPA) just below the point where it divides into the right and left pulmonary
Damus–Kaye–Stansel procedure
11930388
become engorged with brownish hemosiderin. In chronic pulmonary edema, alveolar septa become thick and fibrous, again increasing pressure on alveolar capillaries and resulting in leakage of red blood cells which undergo phagocytosis by alveolar macrophages. Heart failure cell Heart failure cells are siderophages (hemosiderin-containing macrophages) generated in the alveoli of patients with left heart failure or chronic pulmonary edema, when the high pulmonary blood pressure causes red cells to pass through the vascular wall. Siderophages are not specific of heart failure. They are present wherever red blood cells encounter macrophages. In left heart failure, the left ventricle can not keep
Heart failure cell
11930387
Heart failure cell Heart failure cells are siderophages (hemosiderin-containing macrophages) generated in the alveoli of patients with left heart failure or chronic pulmonary edema, when the high pulmonary blood pressure causes red cells to pass through the vascular wall. Siderophages are not specific of heart failure. They are present wherever red blood cells encounter macrophages. In left heart failure, the left ventricle can not keep pace with the incoming blood from the pulmonary veins. The resulting backup causes increased pressure on the alveolar capillaries, and red blood cells leak out. Alveolar macrophages (dust cells) engulf the red blood cells, and
Heart failure cell
14501295
over the pulmonary area may reveal the palpable tap of pulmonary valve closure (palpable P2) in cases of pulmonary hypertension. Parasternal heave occurs in the setting of right ventricular enlargement (hypertrophy) or very rarely severe left atrial enlargement. This is due to the position of the heart within the chest: the right ventricle is most anterior (closest to the chest wall). Hypertrophy of the right side of the heart will occur when the right side of the heart chronically contracts against higher pressure. This occurs in the setting of valvular disease i.e. pulmonary valve, and in the setting of respiratory
Parasternal heave