Hiatus Hernia and Reflux Hiatus Hernia Definition Protrusion of part of the stomach through the diaphragmatic oesophageal opening ▪ Type 1 – sliding hernia (the commonest type): the gastro-oesophageal junction (GOJ) slides proximally through the diaphragmatic hiatus to assume an…
Conventional Coronary Angiography and Echocardiography Conventional Coronary Angiography This involves the selective injection of contrast medium into the right and left coronary arteries and the left ventricle (while recording the resultant moving images) Being replaced by non-invasive CCT and CMR…
Gastrointestinal Vascular Disorders Mesenteric Haemorrhage Upper gastrointestinal (GI) haemorrhage This is defined as bleeding proximal to the duodenal–jejunal flexure (most commonly from the left gastric artery) Causes: peptic ulceration ▸ pancreatitis ▸ gastro-oesophageal varices ▸ as a complication of endoscopic,…
Aortic Rupture Traumatic Aortic Injury (TAI) Definition This occurs as a result of a rapid deceleration injury generating shearing forces at the aortic isthmus ▸ other mechanisms of injury include an AP compression force displacing the heart to the left…
Pulmonary Thromboembolic Disease Pulmonary Thromboembolic Disease Definition A pulmonary embolus (PE) usually arises from a thrombus within a pelvic or lower limb vein (>90%) ▪ ‘Saddle’ embolus: a thrombus lodged at the main pulmonary arterial bifurcation ▪ Pulmonary infarction: This…
Acquired Mitral Valve Disease Mitral Regurgitation Definition An incompetent mitral valve allowing regurgitant flow from the left ventricle (LV) into the left atrium (LA) during systole (mid-to-late systolic murmur) ▸ maintaining an adequate stroke volume requires an increased ventricular stroke…
Introduction Cardiac Development Between the 2 nd and 7 th week of intrauterine life the primitive cardiac tube grows in length more than the fetal trunk – as the ends of this tube are relatively fixed the rapidly elongating cardiac…
Lung Transplantation Lung Transplantation Definition Single lung transplantation This is indicated for non-suppurative lung disease: emphysema ▸ idiopathic pulmonary fibrosis ▸ sarcoidosis ▸ lymphangioleiomyomatosis Bilateral sequential lung transplantation This is indicated for suppurative lung disease: cystic fibrosis ▸ bronchiectasis Preoperative…
Congenital Chest Abnormalities Congenital Pulmonary Airway Malformations (CPAM) Definition Previously known as congenital cystic adenomatoid malformation (CCAM) A rare lesion caused by hamartomatous proliferation of the terminal bronchioles at the expense of alveolar development ▸ it is characterized by a…
Airspace Disease Pulmonary Oedema Definition An excess of extravascular lung water ▪ Cardiogenic oedema: increased hydrostatic pressure moves fluid out of the vascular compartment ▸ this is commonly caused by left heart failure ▸ it is rarely caused by a…