まとめ
リウマチ性心疾患の兆候であるアシュホフ体 (Aschoff bodies) は,左心房付属体の21%とミトラ弁の手術中に切除されたパピラリ筋の2%で発見されました. ほとんどの患者はミトラル狭窄症を患っており,急性リウマチ熱の症状を示す患者は少ない.
科学分野:
- 心血管外科手術についてです.
- レウマトロジーの病理学
- 病理学 パトロジー
背景:
- リウマチ性心疾患 (RHD) は,世界的な健康上の大きな懸念事項であり,しばしばミトラ弁疾患につながる.
- アッショフの遺体は,急性リウマチ熱 (ARF) の病原性組織学的発見である.
研究 の 目的:
- ミトラル弁手術中の心臓組織におけるアシュホフ体の有病率と位置を調査する.
- アシュホフ体の存在と手術前臨床診断とリズム状態を相関させる.
主な方法:
- ミトラル弁の手術を受けた481人の患者の遡及的分析.
- 手術で切除された左心房の付属体と左心室のパピラリ筋の組織病理学的検査.
- 診断と心電図の発見を含む術前臨床データのレビュー.
主要な成果:
- アシュホフの遺体は,切断された191の左心房付属体の40 (21%) と切断された273のパピラリ筋の4 (2%) で特定されました.
- アシュホフ体を持つ45人の患者のうち44人がミトラ管狭窄症であり,1人だけが純粋なミトラ管吐症でした.
- アシュホフ体を持つ患者の大半 (84%) は副鼻腔リズムであった.
- 術後の急性レウマチ熱の兆候を示したのは1人の患者だけであったが,58%はARFと適合する病歴があった.
結論:
- アシュホフの遺体は,リウマチ性心疾患のためにミトラル弁手術を受ける患者の左心房付属体に頻繁に発見されています.
- これらの組織にアシュホフ体の存在は,急性リウマチ熱の症状がない場合でも,慢性的なリウマチ的変化を示す可能性があります.
- 手術用標本の組織病理学的検査は,ミトラ弁疾患の根本的な病因を診断するのに役立ちます.
さらに関連する動画
08:56Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
関連する概念動画
Mechanism of Cardiac Arrhythmias
Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
Disturbances in Heart Rhythm
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Cardiovascular System Abnormal Findings II: Auscultation
Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
Abnormal Heart Sounds
Gallops:
Dysrhythmias III: Characteristics of Dysrhythmias
Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
Dysrhythmias IV: Characteristics of Bradyarrhythmias
Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
