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The Cardiovascular System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
A CABG is a type of thoracic or open-chest surgery in that the sternum is split and the chest opened with a rib-spreader. The lay term open-heart surgery, however, refers to a surgical procedure requiring an incision into the heart. Open-heart surgery includes such procedures as cardiac valve replacements and repair of defects in the atrioventricular septum.
The Normal Heart
Published in P. Chopra, R. Ray, A. Saxena, Illustrated Textbook of Cardiovascular Pathology, 2013
The AV node is arranged as a continuous axis which extends from the atrioventricular septum, penetrates the atrioventricular membranous septum and divides on the crest of the muscular interventricular septum. The atrial component of the AV node is contained exclusively within the Koch's triangle. This triangle is demarcated by the septal leaflet of the tricuspid valve, eustachian valve, and the tendon of Todaro. The apex of the triangle denotes the point at which the common bundle of His penetrates the membranous septum to reach the left ventricle. It then emerges in the subaortic outflow tract beneath the commissure between the non-coronary and right coronary leaflets of aortic valve. The axis branches on the crest of the muscular septum. The left bundle branch then fans out in a continuous cascade splitting into anterior, septal and posterior divisions towards the ventricular apex. The right bundle branch turns back through the interventricular septum as a cord like structure before crossing in the moderator band and ramifying into the right ventricular myocardium. Thus the tissue excised for the study of the conduction system must include the atrioventricular septum, the membranous septum and the rest of the interventricular septum.
Severe deep vein thrombosis and pulmonary embolism in a paediatric patient with primary antiphospholipid syndrome
Published in Modern Rheumatology Case Reports, 2018
Kiwako Tsukida, Norio Shiba, Ryuichi Funada, Michinori Koitabashi, Jun Kawashima, Mayuko Iijima, Yusuke Hara, Haruna Okuno, Hirokazu Arakawa
At admission, her temperature was 36.8 °C, pulse rate was 80 bpm, blood pressure was 100/52 mmHg, and oxygen saturation was 98% in room air. She complained of right femoral pain and oedema; however, the dorsalis pedis artery was palpable and no skin colour change was observed in the lower limbs. No butterfly rash, discoid lupus or signs of photosensitivity were observed. Laboratory investigations revealed mild anaemia (Hb 10.6 g/dL), thrombocytopenia (114 × 109/L), prolonged activated partial thromboplastin time (APTT: 50.7 s) and hyperactivity of fibrinolytic system (FDP 9.1 μg/mL, D-dimer 4.5 μg/mL). Subsequent diagnostic work-up showed triple positivity of the aPL profile [LA (dRVVT) positive (1.70); aCL-IgG: 84.0 U/mL; anti-β2-GP I: 88.4 U/mL]. Although antinuclear antibody titer was elevated 40-fold, anti-double-stranded DNA antibody, PR3-ANCA and MPO-ANCA were negative. Levels of protein C activity, protein S activity and antithrombin III were 84%, 69% and 120%, respectively. Contrast computed tomography (CT) on admission revealed DVT in the right iliofemoral vein and pulmonary thrombosis in both lower pulmonary arteries (Figure 1). Although echocardiography showed no tricuspid regurgitation, she was diagnosed with mild pulmonary hypertension because the atrioventricular septum was flattened. Lung perfusion scintigraphy showed perfusion defect. On magnetic resonance angiography, there were no findings of thrombus in cerebral vessels and no cerebral infarction. Based on these results, she was diagnosed with primary APS with pulmonary thromboembolism (PT) resulting from DVT.