心血管病理
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The diastolic pressure is decreased causing an increase in pulse pressure.
2020/7/12
31
2020/7/12
32
2020/7/12
33
2020/7/12
34
Symptom
No symptom in early stage. The patient may feel palpitation, vertigo(眩晕) and angina in later stage.
2020/7/12
38
2020/7/12
39
Peripheral vascular signs due to increased pulse pressure are as follow:
Moving of head with each heart beat, i.e. Musset sign.
Augmentation of LV volume load results in LVD and relative MI.
2020/7/12
30
The regurgitant jet hits AMV and causes it moving toward LA during diastole, result in relative MS.
2020/7/12
18
Auscultation: A grade three or more pansystolic blowing murmur(全收缩期吹 风样杂音) may be heard and transmitted to the left axilla and scapular region. The first heart sound is decreased and masked by the murmurs. The pulmonary second heart sound was accentuated.
2020/7/12
4
2020/7/12
5
2020/7/12
6
2020/7/12
7
Symptoms
Exhausted dyspnea(劳力性呼吸困难) Occasional paroxysmal nocturnal dyspnea(夜间阵发性呼吸困难) Cough Hemoptysis(咯血)
2020/7/12
37
Auscultation: A blowing diastolic murmur is audible in the aortic area or third interspace left to sternum and transmitted to apex. A rumbling murmur in eraly-mid diastole at apex may be heard due to relative MS. It is called “Austin-Flint” murmur.
2020/7/12
22
2020/7/12
23
2020/7/12
24
2020/7/12
25
Symptom
Palpitation Fatigue Angina(心绞痛) Syncope(晕厥)
2020/7/12
26
Signs
Inspection: The apical impulse is exaggerated, and sometimes is displaced laterally and inferiorly.
2020/7/12
17
Signs
Inspection: The apical impulse is displaced to left and lower.
Palpation: The precordial pulsation is forceful, sustained.
Percussion: The cardiac dullness extends to left and downward.
2020/7/12
21
The blood flow is forced under great pressure through a narrowed aortic valve from LV to the aorta. The wall of LV thicken due to increased afterload. The mean pressure of aorta decreases.
Carotid pulsation
Capillary pulsation, water hammer pulse, pistol shot sound and duroziez dicrotic murmur.
2020/7/12
40
Pericardial Effusion
The commonest causes of PE are inflammatory (tuberculosis or purulent disorders) and noninflammatory (rheumatism, nephrosis肾病).
2020/7/12
12
LV accepts more blood flow during diastole. Over volume load results in LV hypertrophy and dilatation gradually.
2020/7/12
13
2020/7/12
14
2020/7/12
2020/7/12
36
Percussion: The cardiac dullness is enlarged laterally and inferiorly. The “cardiac waist” is decreased. The cardiac silhouette looks like a boot.
2020/7/12
28
2020/7/12
29
Aortic Insufficiency
The cause of AI are rheumatic fever the commonest, arteriosclerosis, infective endocarditis(心内膜炎) and syphilis(梅毒).
2020/7/12
10
2020/7/12
11
Mitral Insufficiency
The main cause of MI is rheumatism, and MI may be produced by LV dilatation due to any cause.
The blood regurgitation into LA from LV during systole. The filling degree and pressure of LA were augmented and then compensatory dilatation of LA occurs.
2020/7/12
19
2020/7/12
ຫໍສະໝຸດ Baidu20
Aortic Stenosis
The valvular deformity in aortic stenosis may be the result of rheumatic fever but also occur on the basis for a congenital defect or atherosclerosis.
2020/7/12
9
Auscultation: A loud snappy first sound and a localized rumbling diastolicmurmur (舒张期隆隆样杂音) in the mid-late stage may be heard at apex. The opening snap may be present. The pulmonary second sound may be accentuated of splitting.
Palpation: A systolic thrill may palpable at the second interspace lateral to the sternal with a pulsus tardus.
Percussion: The cardiac dullness maybe extends to left and downward.
2020/7/12
27
Auscultation: A systolic murmur is heard over the right second interspace lateral to the stenum and radiated widely. The murmur is loud, harsh, and usually has a crescendo-decrescendo charter. A reversed splitting of the second sound is usually seen.
Major Symptom and Sign of Common Disease
in Circulatory System
2020/7/12
1
Mitral Stenosis
MS results from recurrent rheumatic activity.
The flow of blood is damped from LA to LV in diastole, and LA pressure is increased , causing LA dilatation and hypertrophy.
2020/7/12
35
Signs
Inspection: Patients looks pale, the apical impulse is diffuse and displaced laterally or inferiorly.
Palpation: The apical impulse is displaced laterally and inferiorly, lifting impulse may be felt.
15
2020/7/12
16
Symptoms
The patient may feel no symptom for a long time.
The patient has fatigue and palpitation in the early stage.
Exertional dyspnea happens in the terminal stage.
2020/7/12
8
Signs
Inspection: “Mitral Facies” may be present. The apical pulse may extend to left side.
Palpation: diastolic thrill may be felt at apex.
Percussion: The cardiac dullness extend to left in early stage and later to right. The cardiac silhouette is like a pear.
2020/7/12
2
The high atrial pressure induces a dilatation and stasis of pulmonary vein and capillary.
Pulmonary artery pressure increased gradually due to the increased pulmonary circulatory resistance.
2020/7/12
3
The right ventricle is overloaded and then the compensatory hypertrophy and dilatation occur.
Right ventricular failure may be present finally.
2020/7/12
31
2020/7/12
32
2020/7/12
33
2020/7/12
34
Symptom
No symptom in early stage. The patient may feel palpitation, vertigo(眩晕) and angina in later stage.
2020/7/12
38
2020/7/12
39
Peripheral vascular signs due to increased pulse pressure are as follow:
Moving of head with each heart beat, i.e. Musset sign.
Augmentation of LV volume load results in LVD and relative MI.
2020/7/12
30
The regurgitant jet hits AMV and causes it moving toward LA during diastole, result in relative MS.
2020/7/12
18
Auscultation: A grade three or more pansystolic blowing murmur(全收缩期吹 风样杂音) may be heard and transmitted to the left axilla and scapular region. The first heart sound is decreased and masked by the murmurs. The pulmonary second heart sound was accentuated.
2020/7/12
4
2020/7/12
5
2020/7/12
6
2020/7/12
7
Symptoms
Exhausted dyspnea(劳力性呼吸困难) Occasional paroxysmal nocturnal dyspnea(夜间阵发性呼吸困难) Cough Hemoptysis(咯血)
2020/7/12
37
Auscultation: A blowing diastolic murmur is audible in the aortic area or third interspace left to sternum and transmitted to apex. A rumbling murmur in eraly-mid diastole at apex may be heard due to relative MS. It is called “Austin-Flint” murmur.
2020/7/12
22
2020/7/12
23
2020/7/12
24
2020/7/12
25
Symptom
Palpitation Fatigue Angina(心绞痛) Syncope(晕厥)
2020/7/12
26
Signs
Inspection: The apical impulse is exaggerated, and sometimes is displaced laterally and inferiorly.
2020/7/12
17
Signs
Inspection: The apical impulse is displaced to left and lower.
Palpation: The precordial pulsation is forceful, sustained.
Percussion: The cardiac dullness extends to left and downward.
2020/7/12
21
The blood flow is forced under great pressure through a narrowed aortic valve from LV to the aorta. The wall of LV thicken due to increased afterload. The mean pressure of aorta decreases.
Carotid pulsation
Capillary pulsation, water hammer pulse, pistol shot sound and duroziez dicrotic murmur.
2020/7/12
40
Pericardial Effusion
The commonest causes of PE are inflammatory (tuberculosis or purulent disorders) and noninflammatory (rheumatism, nephrosis肾病).
2020/7/12
12
LV accepts more blood flow during diastole. Over volume load results in LV hypertrophy and dilatation gradually.
2020/7/12
13
2020/7/12
14
2020/7/12
2020/7/12
36
Percussion: The cardiac dullness is enlarged laterally and inferiorly. The “cardiac waist” is decreased. The cardiac silhouette looks like a boot.
2020/7/12
28
2020/7/12
29
Aortic Insufficiency
The cause of AI are rheumatic fever the commonest, arteriosclerosis, infective endocarditis(心内膜炎) and syphilis(梅毒).
2020/7/12
10
2020/7/12
11
Mitral Insufficiency
The main cause of MI is rheumatism, and MI may be produced by LV dilatation due to any cause.
The blood regurgitation into LA from LV during systole. The filling degree and pressure of LA were augmented and then compensatory dilatation of LA occurs.
2020/7/12
19
2020/7/12
ຫໍສະໝຸດ Baidu20
Aortic Stenosis
The valvular deformity in aortic stenosis may be the result of rheumatic fever but also occur on the basis for a congenital defect or atherosclerosis.
2020/7/12
9
Auscultation: A loud snappy first sound and a localized rumbling diastolicmurmur (舒张期隆隆样杂音) in the mid-late stage may be heard at apex. The opening snap may be present. The pulmonary second sound may be accentuated of splitting.
Palpation: A systolic thrill may palpable at the second interspace lateral to the sternal with a pulsus tardus.
Percussion: The cardiac dullness maybe extends to left and downward.
2020/7/12
27
Auscultation: A systolic murmur is heard over the right second interspace lateral to the stenum and radiated widely. The murmur is loud, harsh, and usually has a crescendo-decrescendo charter. A reversed splitting of the second sound is usually seen.
Major Symptom and Sign of Common Disease
in Circulatory System
2020/7/12
1
Mitral Stenosis
MS results from recurrent rheumatic activity.
The flow of blood is damped from LA to LV in diastole, and LA pressure is increased , causing LA dilatation and hypertrophy.
2020/7/12
35
Signs
Inspection: Patients looks pale, the apical impulse is diffuse and displaced laterally or inferiorly.
Palpation: The apical impulse is displaced laterally and inferiorly, lifting impulse may be felt.
15
2020/7/12
16
Symptoms
The patient may feel no symptom for a long time.
The patient has fatigue and palpitation in the early stage.
Exertional dyspnea happens in the terminal stage.
2020/7/12
8
Signs
Inspection: “Mitral Facies” may be present. The apical pulse may extend to left side.
Palpation: diastolic thrill may be felt at apex.
Percussion: The cardiac dullness extend to left in early stage and later to right. The cardiac silhouette is like a pear.
2020/7/12
2
The high atrial pressure induces a dilatation and stasis of pulmonary vein and capillary.
Pulmonary artery pressure increased gradually due to the increased pulmonary circulatory resistance.
2020/7/12
3
The right ventricle is overloaded and then the compensatory hypertrophy and dilatation occur.
Right ventricular failure may be present finally.