Sunday, 18 March 2012

Procedures to counter coronary artery disease

An example of a drug-eluting stent. This is the TAXUS Express2 Paclitaxel-Eluting Coronary Stent System, which releases paclitaxel.
Coronary artery bypass surgery (CABG) 
Grafting an artery or vein from elsewhere (typically the leg) to bypass a stenotic coronary artery.
Enhanced external counterpulsation (EECP) 
Pneumatically assisting the heart move blood through cuffs on the legs.
Percutaneous coronary intervention (PCI) 
Procedures to treat stenotic coronary arteries by accessing through a blood vessel.
Percutaneous Transluminal Coronary Angioplasty (PTCA) 
Enlarging the lumen of a coronary artery by forcibly expanding it with a balloon.
Enlarging the lumen of a coronary artery by removal of atherosclerotic plaque.
Enlarging the lumen of a coronary artery by forcibly expanding it with a metal wire tube.

Devices used in cardiology

A stethoscope.
Acoustic device for hearing internal sounds including heart sounds.
Devices used to maintain normal electrical rhythm
An implanted electrical device that replaces the heart's natural pacemaker.
Electrical devices to alter the heart's rhythm with electrical energy.
Automated external defibrillator (AED) 
An external defibrillator that is commonly found outside of health care settings. Often designed for anyone to use.
Implantable cardioverter-defibrillator (ICD) 
An implanted device to prevent life-threatening conditions (e.g., ventricular tachycardia, ventricular fibrillation).
Devices used to maintain blood pressure
Artificial heart
An internal pump that wholly replaces the pumping action of the heart.
Cardiopulmonary bypass (CPB) / heart-lung machine 
External pump to take over the function of both the heart and lungs.
Intra-aortic balloon pump (IABP) 
A balloon placed in the thoracic aorta to supplement cardiac output from the heart.
Ventricular assist device
Internal pump to supplement or replace the pumping action of a ventricle.

Diagnostic tests and procedures

Cardiologists use diagrams like this: a heart with an ECG indicator
Various cardiology diagnostic tests and procedures.
Blood tests
Echocardiography ("echo") 
Ultrasonography of the heart to inspect chambers, valves, and blood flow.
Transthoracic echocardiogram (TTE) 
Echocardiogram of the heart through the thorax external to the body.
Transesophageal echocardiogram (TEE) 
Echocardiogram of the heart through a catheter placed in the esophagus.
Cardiovascular magnetic resonance imaging (CMR) 
Magnetic resonance imaging (MRI) of the heart that utilizes the ECG for gating and to look at specific mechanical functions of the heart.
Cardiac stress test
Testing of the cardiovascular system through controlled exercise or drugs.
Listening to sounds (e.g., heart sounds) with a stethoscope.
Electrocardiography (ECG or EKG) 
Measurement of the electrical activity of the heart, typically with 4 or 10 electrodes on the skin.
Holter monitor
Portable ECG device for continuous monitoring.
Electrophysiology study
Studying the electrical activity of the heart through the use of catheters placed in the heart via veins or arteries.
Blood pressure cuff used to measure arterial blood pressure.
Cardiac marker
Testing for biomarkers in the blood that may indicate various conditions.
Coronary catheterization
Catheterization of the coronary arteries.
Fractional flow reserve (FFRmyo) 
Testing of the flow through a stenosis of a coronary artery to determine the perfusion of the heart.
Intravascular ultrasound (IVUS) 
Ultrasonography of a coronary artery.
Optical coherence tomography (OCT) 
Testing through the use of optical scattering for coronary artery disease.

Diseases of blood vessels (vascular diseases) ,

The progression of atherosclerosis (size exaggerated).
Thickening of an arterial wall due to increased cholesterol and macrophages
Balloon-like bulging of the artery.
Diseases of the aorta
Coarctation of the aorta
Narrowing of the aorta at the ductus arteriosus/ligamentum arteriosum.
Aortic dissection
Dissection along the length of the aorta between the layers of the aortic wall and filled with blood.
Aortic aneurysm
Aneurysm of the aorta.
Carotid artery
Diseases of the carotid arteries
Carotid artery stenosis / carotid artery disease 
Narrowing of the carotid artery, typically due to atherosclerosis.
Carotid artery dissection
Dissection along the length of the carotid artery between the layers of the carotid wall and filled with blood.
Deep vein thrombosis (DVT) 
Formation of a thrombus in a deep vein, commonly in the legs.
Traveller's thrombosis / economy class syndrome 
A DVT due to being sedentary during air travel.
Varicose veins
Veins that have become enlarged and tortuous with failed valves, commonly in the legs.
Inflammation of blood vessels.

cardiovascular system

Human cardiovascular system

Cross section of a human artery
The main components of the human cardiovascular system are the heartblood, and blood vessels.[3] It includes: the pulmonary circulation, a "loop" through the lungs where blood is oxygenated; and the systemic circulation, a "loop" through the rest of the body to provide oxygenated blood. An average adult contains five to six quarts (roughly 4.7 to 5.7 liters) of blood, which consists of plasmared blood cellswhite blood cells, and platelets. Also, the digestive system works with the circulatory system to provide the nutrients the system needs to keep the heart pumping.

Pulmonary circulation

The pulmonary circulatory system is the portion of the cardiovascular system in which oxygen-depleted blood is pumped away from the heart, via thepulmonary artery, to the lungs and returned, oxygenated, to the heart via the pulmonary vein.
Oxygen deprived blood from the vena cava, enters the right atrium of the heart and flows through the tricuspid valve (right atrioventricular valve) into the right ventricle, from which it is then pumped through the pulmonary semilunar valve into the pulmonary artery to the lungs. Gas exchange occurs in the lungs, whereby CO2 is released from the blood, and oxygen is absorbed. The pulmonary vein returns the now oxygen-rich blood to the heart.

Systemic circulation

Systemic circulation is the portion of the cardiovascular system which transports oxygenated blood away from the heart, to the rest of the body, and returns oxygen-depleted blood back to the heart. Systemic circulation is, distance-wise, much longer than pulmonary circulation, transporting blood to every part of the body.

View from the front, which means the right side of the heart is on the left of the diagram (and vice-versa)

Coronary circulation

The coronary circulatory system provides a blood supply to the heart. As it provides oxygenated blood to the heart, it is by definition a part of the systemic circulatory system.


The heart pumps oxygenated blood to the body and deoxygenated blood to the lungs. In the human heart there is one atrium and one ventricle for each circulation, and with both a systemic and a pulmonary circulation there are four chambers in total: left atriumleft ventricleright atrium and right ventricle. The right atrium is the upper chamber of the right side of the heart. The blood that is returned to the right atrium is deoxygenated (poor in oxygen) and passed into the right ventricle to be pumped through the pulmonary artery to the lungs for re-oxygenation and removal of carbon dioxide. The left atrium receives newly oxygenated blood from the lungs as well as the pulmonary vein which is passed into the strong left ventricle to be pumped through the aorta to the different organs of the body.

Closed cardiovascular system

The cardiovascular systems of humans are closed, meaning that the blood never leaves the network of blood vessels. In contrast, oxygen and nutrients diffuse across the blood vessel layers and enters interstitial fluid, which carries oxygen and nutrients to the target cells, and carbon dioxide and wastes in the opposite direction. The other component of the circulatory system, the lymphatic system, is not closed.

Oxygen transportation

About 98.5% of the oxygen in a sample of arterial blood in a healthy human breathing air at sea-level pressure is chemically combined with haemoglobin molecules. About 1.5% is physically dissolved in the other blood liquids and not connected to haemoglobin. The haemoglobin molecule is the primary transporter of oxygen in mammals and many other species.

An animation of a typical human red blood cell cycle in the circulatory system. This animation occurs at real time (20 seconds of cycle) and shows the red blood cell deform as it enters capillaries, as well as changing color as it alternates in states of oxygenation along the circulatory system.


The development of the circulatory system initially occurs by the process of vasculogenesis. The human arterial and venous systems develop from different embryonic areas. While the arterial system develops mainly from the aortic arches, the venous system arises from three bilateral veins during weeks 4 - 8 of human development.

Arterial development

The human arterial system originate from the aortic arches and from the dorsal aortae starting from week 4 of human development. Aortic arch 1 almost completely regresses except to form the maxillary arteries. Aortic arch 2 also completely regresses except to form the stapedial arteries. The definitive formation of the arterial system arise from aortic arches 3, 4 and 6. While aortic arch 5 completely regreses.
The dorsal aortae are initially bilateral and then fuse to form the definitive dorsal aorta. Approximately 30 posterolateral branches arise off the aorta and will form the intercostal arteries, upper and lower extremity arteries, lumbar arteries and the lateral sacral arteries. The lateral branches of the aorta form the definitive renalsuprarrenal and gonadal arteries. Finally, the ventral branches of the aorta consist of the vitelline arteries and umbilical arteries. The vitelline arteries form the celiacsuperior and inferior mesenteric arteries of the gastrointestinal tract. After birth, the umbilical arteries will form the internal iliac arteries.

Venous development

The human venous system develops mainly from the vitelline veins, the umbilical veins and the cardinal veins, all of which empty into the sinus venosus.

Measurement techniques

  • Electrocardiogram—for cardiac electrophysiology
  • Sphygmomanometer and stethoscope—for blood pressure
  • Pulse meter—for cardiac function (heart rate, rhythm, dropped beats)
  • Pulse—commonly used to determine the heart rate in absence of certain cardiac pathologies
  • Heart rate variability -- used to measure variations of time intervals between heart beats
  • Nail bed blanching test—test for perfusion
  • Vessel cannula or catheter pressure measurement—pulmonary wedge pressure or in older animal experiments.



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