文档介绍:Valvular Heart Disease
心脏瓣膜病类型讲解
ValvularHeartDisease心脏瓣膜病类型讲解
心脏瓣膜病 是指心瓣膜及瓣下装置由于炎症、变性、粘连、缺血性坏死、创伤、老化或钙质沉着及先天性发育异常等原因,使单个或多个瓣膜发生急性或慢性的狭窄或关闭不全,导致前向血流障碍和/或返流的一组疾病。临床上最常受累的为二尖瓣,其次为主动脉瓣。
风湿性心脏病 简称风心病,仍是我国主要的心脏病,是风湿性炎症过程所致瓣叶损害。根据人群发病率调查已有下降趋势。
ValvularHeartDisease心脏瓣膜病类型讲解
Mitral valve disease
二尖瓣疾病
ValvularHeartDisease心脏瓣膜病类型讲解
Mitral stenosis (MS)
二尖瓣狭窄
ValvularHeartDisease心脏瓣膜病类型讲解
Etiology and Pathology(病因和病理)
Rheumatic heart disease (风湿性心脏病)
Congenital malformation (先天性畸形)
Senile mitral annulus and subvalvular calcification (老年人二尖瓣环及环下区钙化)
ValvularHeartDisease心脏瓣膜病类型讲解
Pathophysiology(病理生理)
The cross-sectional area of the mitral valve orifice (瓣环口面积)
Normal adults 4 - 6cm²
Mild MS ≤2cm²
Moderate MS ≤²
Severe MS ≤²
ValvularHeartDisease心脏瓣膜病类型讲解
The effect on LA and cardiac output of MS
Mild MS:LA压力轻度升高,心排血量正常
Severe MS:跨瓣压差增大(20mmHg) →LA压力升高(25mmHg);休息时心排血量正常或减少
The effect on the pulmonary circulation and respiration of elevated left atrium pressure
ValvularHeartDisease心脏瓣膜病类型讲解
LA →PVP、PCP →lung congestion /pulmonary edema pulmonary artery intima hyperplasia and thickening (肺动脉内膜增生肥厚) PAP(肺动脉压升高) Right heart failure(右心衰竭)
ValvularHeartDisease心脏瓣膜病类型讲解
Remarks (备注)
PAP:肺动脉压
PCP:肺毛细血管压
PVP肺静脉压
ValvularHeartDisease心脏瓣膜病类型讲解
Clinical situation(临床表现)
一、Symptom (中度狭窄始出现症状)
Exertion dyspnea(劳力性呼吸困难)
Hemoptysis(咯血)
支气管静脉压↑破裂出血
肺梗死
肺水肿
ValvularHeartDisease心脏瓣膜病类型讲解