Transcript

Taking a Look Under Your Skin!

Andrew Scott

A Human Heart

The Circulation

The Heart

Right Atrium

Right Ventricle

Left Atrium

Left Ventricle

The Cardiac Cycle

The Coronary Arteries•The heart is a big muscle so needs a blood supply to work.

•It doesn’t use the blood inside the heart it has it’s own blood vessels.

•These arteries are called the coronary arteries and are very important.

A coronary artery

Heart Diseases

•UK’s biggest killer40% of all deaths

www.heartstats.org

240,000PEOPLE DIE OF HEART DISEASE EVERY YEAR!!!!!

Coronary Artery Disease

KILLS 120,000 PEOPLE PER YEAR!!!

Fat in your artery.

What happens to all that fat?

• It can cause chest pain – ANGINA.• It gets bigger and can stop the blood to the

heart – a HEART ATTACK.• OR it can break off and:

– Get stuck on the way to the heart – a HEART ATTACK.

– Get stuck in your lungs – PULMONARY EMBOLISM.

– Get stuck in your brain – a STROKE.

Imaging the Heart

X-Ray Contrast Angiography

• X-RAY– All we see is ribs when we x-ray the heart.

• To see the heart and blood vesselswe inject iodine CONTRAST into a vein which absorbs x-rays like bone.

• Taking pictures of vessels like this is called ANGIOGRAPHY.

Angiography of the coronary arteries

Fat

What the coronary arteries would look like

Nor

mal

With

a p

laqu

e

What we see in x-ray contrast angiography

Vessel wall

Blood

Thin bit where disease is

Nor

mal

With

a p

laqu

e

A real x-ray contrast angiography!

Ultrasound

• High frequency sound waves.• Put small probe on skin between ribs.• See valves and heart moving.

Which is best?

X-ray Contrast Angiography• Is good for seeing coronary

arteries.• Uses ionising radiation.

• Need to inject iodine contrast dye.

Ultrasound• Is good for seeing the valves

move.• Uses high frequency sound

waves.• Need to look between the

ribs.

Both have their uses but neither is ideal.

Magnetic Resonance Imaging – MRI

What can we get pictures of?

Back to the heart!

MRI Coronary Angiogram

One of my coronary arteries!

Movies of the Heart

Slicing up the Body

Tagging

We can see how the different bits of the heart move.

Tagging

Valve Movement

Blood Flow

Black – Blood flows in to the screen.White – Blood flows out of the screen.

A Faulty Valve

Watch for the jet of blood shooting backwards through the valve!

Contrast Agent

• If we inject a gadolinium compound (contrast agent) the magnetic field is increased wherever the contrastagent goes.

• The increased magneticfield means that the radiowave comes back more quickly.

Heart Disease

Vascular MRI

Kidneys

Vascular MRI

Aorta and Lungs

Pictures of the brain!

Pictures of your thoughts!

• When you use part of your brain, extra blood flows to that part of your brain with more oxygen.

• Oxyhaemoglobin and deoxyhaemoglobin alter the magnetic field, changing how quick the radio waves come back.

Mind Reading

Mind Reading

Mind Reading

A Multi-Disciplinary Team

Thank you for listening!

[email protected]

Andrew ScottPhD Student (in Physics)

Cardiovascular Magnetic Resonance UnitRoyal Brompton and Harefield NHS Trust.National Heart and Lung Institute, Imperial College.


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