心脏瓣膜病3PPT课件

Valvular Heart Disease心脏瓣膜病心脏瓣膜病 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。Mitral valve disease Mitral stenosis (MS)Etiology and Pathology（病因和病理）Pathophysiology(病理生理)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）Remarks(备注)Clinical situation(临床表现)3.Hoarseness（声嘶）4.Cough(咳嗽）LA增大压迫左主支气管，支气粘膜淤血水肿，易致感染 扩大的LA、肺A压迫喉返NClinical situationLaboratory examination(实验室检查)Echocardiogram(超声心动图)：是确诊、定量MS的可靠方法u M型：二尖瓣前后叶同向运动u 二维：狭窄瓣膜形态结构，瓣口面积，房室大小u 连续多普勒：测定血流速度、跨瓣压差Cardiac catheterization(心导管术)u 测定肺毛细血管压和左室压，确定跨瓣压差，明确狭窄程度Diagnosis and Differential diagnosis(诊断和鉴别)Complication（并发症）Complication（并发症）Prognosis(预后)Therapy(治疗)Therapy(治疗)Mitral incompetence:MIEtiology and Pathology（病因病理）一、Chronic MI一、Chronic MICalcification of mitral ring and subvalvular(二尖瓣环及环下区钙化)5.Infective endocsrditisRupture of chordae tendineae(unknown cause)7.LV enlarged significantly(左室显著扩大)Else 二、Acute MI1.Rupture of chordae tendineae(PathophysiologyClinical situation(临床表现)Laboratory examinationDiagnosis and Differential diagnosisComplicationPrognosisTherapyAortic Valve DiseaseAortic stenosis(AS)Etiology and PathologyPathophysiologyClinical situationClinical situationLaboratory examinationDiagnosis and Differential diagnosisComplicationPrognosisMedicine therapyPBAP:Percutaneous balloon aortic valvuloplasty(经皮球囊主动脉瓣成形术)Aortic incompetenceEtiology and pathologyEtiology and pathologyEtiology and pathologyPathophysiologyRemarks(备注)Clinical situationClinical situationLaboratory examinationDiagnosis and Differential diagnosisComplicationTherapyTherapyMultivalvular heart diseaseEtiology Pathophysiology Examples of common multivalvular heart diseaseTherapy