Glossary of Terms
Angiogram
A series of motion pictures taken of the blood vessels in a living patient. Angiograms are
usually done in a selective manner, where only certain vessels are injected with a special
x-ray sensitive dye and photographed with high speed cameras. The procedure takes place
with the patient laying quietly on a specialized fluoroscopy table. Detailed anatomical
roadmaps of the blood vessels can be obtained. These studies provide the essential
information for diagnosing and treating arterial blockages in any system of the body,
including the heart..
Angioplasty
Balloon dilatation...a procedure where an arterial blockage is expanded, or dilated, with
a balloon. The procedure takes place under x-ray guidance in the cardiac catheterization
laboratory. Expansion of the obstructing plaque can, in some cases, restore the flow
channel and relieve symptoms of angina.
Anticoagulation
Treatment of clotting disorders with medications that impair the ability of the blood to
form clots. The most commonly used blood thinner is warfarin (also known as Coumadin®
Anticoagulants
Blood Thinners...medications which reduce or impair the ability of the blood to form
clots. These medications are used to retard clot formation on artificial devices or in
certain. The most common medications are oral warfarin (or Coumadin®) and intravenous
heparin
Annulus
A ring of tough fibrous tissue at the base of the heart. This ring supports and anchors
the heart valve(s) into the heart itself. There are 4 valve annuli...one each for the
tricuspid, mitral, aortic, and pulmonary valves. These rings of fibrous tissue all
converge together in the middle of the heart, and area known as the fibrous skeleton of
the heart.
Aorta
The main blood vessel carrying all of the fresh blood out of the heart to the body. The
aorta comes directly out of the heart and then courses through the body providing branches
which deliver nourishing blood supply to every organ and tissue
Aortic Root
The opening at the junction between the heart chamber and the aorta itself. The root is
characterized by an encircling band of firm fibrous tissue (the annulus) and the leaflets
of the aortic valve.
Artery
Red blood...arteries are the blood vessels that carry the red or oxygen-rich blood away
from the heart and towards the organs of the body. The arteries are thicker and stronger
then veins. The blood pressure in the arteries is nearly 8 times higher than the blood
pressure in the veins. Arteries are vulnerable to atherosclerosis and plaquing, while
veins to not develop these degenerative lesions. The principle artery of the body (called
the aorta) arises from the heart and delivers blood through its many branches to every
tissue of the body.
Atrium
The upper heart chamber, also known as the auricle. The atria act as a temporary resevoir
for blood before sending it to the the lower heart chambers.
Atrial Septal Defect (ASD)
Hole in the heart...a residual communication between the two upper heart chambers. In most
hearts, the flow is from the red side towards the blue (or right) side of the heart. This
causes overload of the right heart, but is usually well tolerated. There are several
varieties of ASDs depending on the location and associated abnormalities. Repair is by
direct suture closure or patch closure.
Cardiac Catheterization
A series of invasive examinations of the heart, typically including detail pressure
measurements within the heart chambers, x-ray photographs (angiograms) of the pumping
chambers and the coronary arteries, and the calculation of certain values based on these
studies. The cardiac catheterization report is a summary of many different normal and
abnormal states affecting the patient. The procedure requires the patient remain
motionless under the fluoroscopy table until the measurements and pictures are completed.
This study is the gold standard for diagnosis of most cardiac conditions.
Cardiopulmonary Bypass (CPB)
Another name for extracorporeal circulation (ECC).
Cath Lab
The specialized radiologic suite where cardiac catheterization is performed.
Congestive Heart Failure
Build up of fluid in the body...a condition of generalized fluid retension causing
swelling and shortness of breath. When the heart cannot deliver enough blood to the body,
then fluid is retained in the lungs or other tissues. Patients with severe heart failure
are incapacitated by symptoms of shortness of breath, air hunger when laying flat,
fatigue, swelling in the feet, and other problems. Reduced life expectancy is common.
There are many causes, including valve or coronary disease.
Coronary Artery(ies)
The blood vessels which bring red (oxygen-rich) blood to nourish the muscle cells of the
beating heart.
Eisenmengers Syndrome
A name for the reversal of blood flow across a cardiac defect with the appearance of
cyanosis in an adult. This occurs when the resistance to blood flow in the lungs gets so
high that blood now goes right-to-left across the remaining heart defect instead of
left-to-right. The patient becomes cyanotic (blue). Generally this signals a gradual
decline towards death from end stage heart failure. The presence of Eisenmengers also
signals that the defects are now uncorrectable with surgery.
Embolism
The name of an event where clots detach from their source and migrate through the
circulation to another blood vessel or body organ.
Endocarditis or SBE
Valve Infection...Subacute Bacterial Endocarditis (SBE) refers to a progressing infection
of the heart valve, leading to destruction of the valve leaflets, fibrous support
structures, and other consequences.
Extracorporeal Circulation (ECC)
The technique of mechanically circulating the blood so the heart doesn't have to. The
device used for ECC is called the heart-lung machine or the cardiopulmonary bypass
circuit. This device drains the blue blood from the patient, places oxygen in the blood,
and returns (or pumps) the red blood back into the aorta for distribution to the whole
body. To prevent clotting in the heart-lung circuit, strong anticoagulation with heparin
is needed.
Gradient
Pressure difference...the term "gradient" is used to specify the difference in
blood pressure before and after a blockage or stenosis. The gradient is a pressure
difference (calculated by subtracting the higher pressure before a blockage from the lower
pressure beyound the blockage). The severity of a blockage and the impact on circulation
hemodynamics can be estimated by the magnitude of the gradient. This is particularly
useful in estimating the severity of obstructive heart valve conditions.
Heart-Lung Machine
Another term for machine which provides extracorporeal circulation (ECC)
Hemodynamics
Hydrolic performance...a term loosely used to describe the throughput of blood when
referring to the performance of a heart, circulation, or a device in the circulatory
system. There are several key measurements which compose the assessment of hemodynamic
performance, such as the flow (i.e. volume of blood per minute), the flow velocity, and/or
the pressure gradient needed to achieve the measured flow.
Hemorrhage
Bleeding
Left Atrium
The upper (or "priming") pumping chamber on the left side of the heart. The left
atrium sits above the mitral valve and gently forces blood across the mitral valve into
the left ventricle. This actions "primes" the lower pumping chamber to improve
efficiency. At the same time, the left atrium provides a temporary storage site for blood
returning from the lungs during the time that the left ventricle is actually squeezing.
Left Ventricle
The main pumping chamber of the heart. Oxygen-rich blood is pumped out of the left
ventricle during a heart contraction and ejected into the aorta for distribution
throughout the body.
Pulmonary Artery
The large artery which leaves the right ventricle and carries the blue blood into the
lungs where oxygen is absorbed.
Pulmonary Hypertension
Elevated blood pressure in the lungs...When the resistance to blood flow in the lungs goes
up, the pressure in the pulmonary arteries also increases. The presence of pulmonary
hypertension indicates either high blood flow, high resistance, or both. If left
untreated, this can lead to heart failure, cyanosis, and eventually serious consequences
including death. However, some patients tolerate elevated pressures in the lung arteries
for many years.
Pulmonary Vascular Obstructive Disease (PVOD)
Irreversible changes in the small arteries bringing the blue blood towards the lungs. PVOD
is usually a consequence of chronic overcirculation of the lungs. Once it becomes
established, PVOD causes increased resistance to blood flow and thus pulmonary
hypertension. It is a serious consequence of uncorrected congenital heart disease.
Right atrium
The upper (or "priming") pumping chamber on the right side of the heart. The
right atrium sits above the tricuspid valve and gently forces blood across the tricuspid
valve into the right ventricle. This actions "primes" the lower pumping chamber
to improve efficiency. At the same time, the right atrium provides a temporary storage
site for blood returning from the lungs during the time that the right ventricle is
actually squeezing.
Right Ventricle
The pumping chamber on the right side of the heart which pumps oxygen-poor blood into the
pulmonary artery on its way towards the lungs.
Septum
This name stands for the muscular wall separating two independent chambers of the heart.
There is a separate septum which divides the two upper chambers (or atria) and a septum
dividing the two lower chambers (or ventricles). The ventricular septum is more muscular
and constitutes part of the pumping chamber itself.
Stenosis
Blockage or obstruction...a termed used to descibe an area or zone of narrowing in any
channel, including the small coronary vessels.
Thrill
A buzzing sensation felt along the course of a turbulent blood vessel. The sensation is
best appreciated with the palm of the hand. A thrill indicates high turbulence of blood
flow and is associated with a loud murmur (the audible expression of turbulence).
Thromboembolism
Both clotting and embolic migration...in the same patient
Thrombosis
Clotting...The formation of blood clots on, or inside, of a blood vessel, heart chamber,
or medical device
Tricuspid Valve
A 3 leaflet valve protecting the orifice between the upper and lower chambers on the right
side of the heart (the right atrium and right ventricle. The tricuspid valve is also known
as an atrioventricular valve.
Vein
Blue blood...veins are the blood vessels that carry the oxygen-poor or blue blood from the
body towards the heart.
Vena Cava
The large veins leading blue or unoxygenated blood into the right heart from the body.
Ventricle
The strong pumping chamber that ejects blood from the heart. In the normal heart, there
are two lower chambers called venticles, one on the right (which pumps blue blood to the
lungs) and one on the left side of the heart (which pumps red blood to the body). In
malformed hearts, the position and alignment of the ventricular chambers can be
considerably altered, but the function of pumping blood out of the heart remains the same.
Ventricular Septal Defect (VSD)
Hole in the heart...specifically a residual communication between the two lower heart
chambers. The higher blood pressure is usually on the red (or left) side of the heart, so
the blood flow across the defect is towards the lower pressure (right) side. In some
complex congenital defects the pressure and flow are reversed. VSDs vary in size and
location. Repair depends on the anatomy and the location of the defect. |
