心脏瓣膜病课件-.ppt

1、Valvular Heart Disease1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。2Mitral valve disease 3Mitral stenosis (MS)4Etiology and Pathology（病因和病理）5Pathophysiology(病理生

2、理)67LA 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）8Remarks(备注)9Clinical situation(临床表现)103.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N11Clinical situation12Laboratory examination(实验室检查)

3、13u 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14Diagnosis and Differential diagnosis(诊断和鉴别)15Complication（并发症）16Complication（并发症）17Prognosis(预后)18Therapy(治疗)19Therapy(治疗)20Mitral incompetence:MI21Etiology and Pathology（病因病理）22一、Ch

4、ronic MI23一、Chronic MI24二、Acute MI25Pathophysiology26Clinical situation(临床表现)27Laboratory examination28Diagnosis and Differential diagnosis2930Complication31Prognosis32Therapy3334Aortic Valve Disease35Aortic stenosis(AS)36Etiology and Pathology37Pathophysiology3839Clinical situation40Clinical situat

5、ion41Laboratory examination42Diagnosis and Differential diagnosis43Complication44Prognosis45Medicine therapy46PBAP:Percutaneous balloon aortic valvuloplasty(经皮球囊主动脉瓣成形术)47Aortic incompetence48Etiology and pathology49Etiology and pathology50Etiology and pathology51Pathophysiology52Remarks(备注)53Clinical situation54Clinical situation55Laboratory examination56Diagnosis and Differential diagnosis57Complication58Therapy59Therapy60Multivalvular heart disease61Etiology 62Pathophysiology 63Examples of common multivalvular heart disease64Therapy 65