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Cardiovascular system
Atrioventricular block
Heart blocks: Pathology review
Bundle branch block
Pulseless electrical activity
Atrial fibrillation
Atrial flutter
Atrioventricular nodal reentrant tachycardia (AVNRT)
Premature atrial contraction
Wolff-Parkinson-White syndrome
Supraventricular arrhythmias: Pathology review
Brugada syndrome
Long QT syndrome and Torsade de pointes
Premature ventricular contraction
Ventricular fibrillation
Ventricular tachycardia
Ventricular arrhythmias: Pathology review
Cardiac tumors
Atrial septal defect
Coarctation of the aorta
Patent ductus arteriosus
Ventricular septal defect
Acyanotic congenital heart defects: Pathology review
Hypoplastic left heart syndrome
Tetralogy of Fallot
Transposition of the great vessels
Truncus arteriosus
Total anomalous pulmonary venous return
Cyanotic congenital heart defects: Pathology review
Cardiovascular changes during hemorrhage
Aneurysms
Aortic dissection
Aortic dissections and aneurysms: Pathology review
Angina pectoris
Coronary steal syndrome
Stable angina
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Coronary artery disease: Pathology review
Abetalipoproteinemia
Familial hypercholesterolemia
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Atherosclerosis and arteriosclerosis: Pathology review
Dyslipidemias: Pathology review
Coarctation of the aorta
Hypertension
Hypertension: Pathology review
Hypertensive emergency
Pheochromocytoma
Polycystic kidney disease
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Shock
Shock: Pathology review
Peripheral artery disease
Subclavian steal syndrome
Peripheral artery disease: Pathology review
Behcet's disease
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Vasculitis
Vasculitis: Pathology review
Chronic venous insufficiency
Deep vein thrombosis
Thrombophlebitis
Angiosarcomas
Human herpesvirus 8 (Kaposi sarcoma)
Vascular tumors
Cardiac and vascular tumors: Pathology review
Coarctation of the aorta
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coarctation of aorta p. 305
labs/findings p. 720
coarctation of aorta and p. 305
Turner syndrome p. 661
coarctation of aorta p. 305
coarctation of aorta and p. 305
Coarctation is a fancy way of saying “narrowing,” so a coarctation of the aorta means a narrowing of the aorta. If we look at the heart, we’ve got the right and left atria, the right and left ventricles, the pulmonary artery leaving the right ventricle to go to the lungs, and the aorta leaving the left ventricle to go to the body.
There are two forms of aortic coarctation to be familiar with: an “infant” form and an “adult” form. With the infant form, which accounts for about 70% of cases, the coarctation comes after the aortic arch, which branches off to the upper extremities and to the head, and before the ductus arteriosus. Now, you might be thinking, “Hey, what’s this ductus arteriosus thing doing here?” Well, typically this guy only exists during fetal development and closes after birth, but with infantile coarctation, the ductus arteriosus is usually still open, or patent, so there’s a patent ductus arteriosus. In fact, sometimes this form is also called preductal coarctation.
So, if we draw out a more simplified version of the heart, we’ve got deoxygenated blood coming into the right atrium that flows into the right ventricle. Now, as it’s pumped out of the pulmonary artery, it’s got two choices, right? One option is to go through the patent ductus arteriosus and continue down the aorta; the other option is to continue down the way it’s going. Well, since it’s higher pressure over here on the left side, you might think that the blood would say “thanks, but no thanks,” and keep going down the lower pressure pulmonary artery. Instead, this aortic coarctation adds a little twist. Since the spot right before the ductus arteriosus is narrower, blood flowing from the left side has a harder time going through, so actually there’s high pressure upstream of the coarctation, but low pressure downstream. So, what happens is that blood decides to go this way, through the patent ductus arteriosus and into the lower pressure area in the systemic circulation, and then continues down to the lower extremities, rather than the slightly higher pressure pulmonary artery. This gives you a real sense of exactly how much this coarctation reduces the pressure over on the systemic side.
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