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1、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
2、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(
3、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、Ch
4、ronic 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 D
5、ifferential diagnosisComplicationPrognosisTherapyAortic Valve DiseaseAortic stenosis(AS)Etiology and PathologyPathophysiologyClinical situationClinical situationLaboratory examinationDiagnosis and Differential diagnosisComplicationPrognosisMedicine therapyPBAP:Percutaneous balloon aortic valvuloplas
6、ty(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
心脏瓣膜病3PPT课件
