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Pathology: the heart of modern healthcare

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Page 1: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Pathology: the heart of modern healthcare

Page 2: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 3: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 4: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 5: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Broken heart

• Young at heart

• With all my heart

• Heart to heart

• My heart sank

• Hand on my heart

• Queen of hearts

• Heart and soul

Page 6: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: coronary heart disease is the biggest cause of death in the

UK

Page 7: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: 1 in 5 deaths in the UK are from coronary heart disease

Page 8: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• The heart is a muscle

• It pumps blood around the body

• The heart has 4 chambers, 2 on the right and 2 on the left

Page 9: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Dual circulation

• Left high pressure

• Right low pressure

• Oxygen added to blood in lungs

• Oxygen delivered to body by blood

Page 10: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: nearly 70,000 men and 50,000 women have a heart attack

in the UK each year

Page 11: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

How can doctors look at the heart?

•Scanners

•X-rays

•ECG

•Echocardiography

Page 12: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: heart disease costs the economy £9 billion each year

Page 13: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

How do pathologists investigate the heart?

•Blood tests

•Biopsies

•Genetic tests

•Blood cultures

•Autopsies

Page 14: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

R

LR

Page 15: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Normal artery wall

Fatty deposits in wall of artery

Fatty deposits reduce blood flow through

artery

Blood within the

artery

Atheroma

Page 16: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Atheroma

Fatty deposits reduce blood flow through

artery

Normal artery wall

Page 17: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Artery blocked by blood clot

Page 18: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 19: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Risk factors for CHD• Smoking

• Obesity

• Lack of exercise

• Diet

• High cholesterol

• High blood pressure

Suzannah Lishman
Page 20: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: smoking doubles your risk of having a heart attack

Page 21: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 22: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: stopping smoking reduces your risk of having a heart

attack by a third

Page 23: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: almost half of all heart attacks are caused by high fat

levels in the blood

Page 24: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 25: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: if you have a high cholesterol level, you are three

times more likely to have a heart attack than someone with a normal

level

Page 26: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: around 30% of heart disease is due to not eating enough

fruit and vegetables

Page 27: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 28: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 29: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: around 20% of heart disease is caused by not doing

enough exercise

Page 30: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 31: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: only 40% of men and 28% of women meet the guidelines

for physical activity

Page 32: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: being overweight doubles your chance of having a

heart attack

Page 33: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 34: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 35: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: diabetes increases your chance of having a heart attack and

increases the effect of other risk factors

Page 36: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 37: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: the heart is formed during the first 12 weeks of

pregnancy

Page 38: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 39: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: over 4,500 babies are born with congenital heart disease

in the UK each year

Page 40: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 41: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Heart fact: over 80% of babies with congenital heart disease now

survive to adulthood

Page 42: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Pathology fact: over 70% of diagnoses in the NHS involve

pathology

Page 43: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Pathology fact: over 700 million pathology tests are performed in the

NHS each year

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Page 45: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

The study of disease in human tissue

Histopathologists:•Are doctors•Look at cells and tissues removed in clinic or during an operation•Diagnose diseases including cancer•Work as part of teams•Some perform autopsies

Page 46: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• When someone has a heart transplant, histopathologists look at the heart to find out what was wrong with it

• They also look at biopsies from transplanted hearts to see if they are being rejected

• If someone dies of heart disease a histopathologist might examine the heart to find out what happened

Page 47: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 48: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Dilated cardiomyopathy

Page 49: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 50: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

The study of chemicals in the blood and body fluids

Clinical biochemists•Are scientistsChemical pathologists•Are doctors

Both work in outpatient clinics, on hospitals wards and in the lab.Some tests are now done by patients at home.

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Clinical biochemists:• Measure cholesterol levels

in the blood• Measure the levels of

heart enzymes in the blood

• Diagnose and treat diabetes

• Measure chemicals in the blood that indicate how well the heart is working

Page 52: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 53: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

The study of infectious diseases•Microbiologists can be doctors or scientists•They perform tests to find out which antibiotics will be effective against an infection•And make sure that infections don’t spread from one patient to another•They work with patients and in the lab.

Page 54: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Microbiologists:• Detect organisms in the

blood that might cause infection of the heart muscle or valves

• Prevent, diagnose and treat the infections that are risk factors for coronary heart disease

• Prevent infections in people with congenital heart disease or transplants

Page 55: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 56: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

The study of the blood and bone marrow

Haematologists:•Are doctors•Diagnose and treat anaemia, leukaemia and lymphoma•Work in outpatients clinics, on hospital wards and in the lab.

Page 57: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• The branch of pathology concerned with transfusion of blood and its components

• Makes sure that blood transfusions are safe

• Makes sure that donor and recipient blood groups match

Page 58: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Haematologists diagnose and treat anaemia, which can have an effect on the heart

• They also measure blood clotting to try and prevent blood clots which might cause a heart attack

• You might need a transfusion after heart surgery to replace blood lost

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• 2.1 million blood donations were collected in 2008 from 1.6 million donors

• There are 4 blood groups; Group O is the most common in the UK

Page 60: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• The study of DNA and how diseases are inherited

• Geneticists are usually scientists, some also have a medical degree

• Technological advances in the last 20 years have had a huge impact on genetics

Page 61: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Diagnose inherited forms of heart disease

• Screen family members following unexpected cardiac death

• Look at inherited risk factors for heart disease e.g. high cholesterol

• Working on tests and treatments for inherited heart disease

Page 62: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of
Page 63: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

Hypertrophic cardiomyopathy

Page 64: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

The study of disorders of the immune system

•e.g. allergies, immunodeficiency disorders

•Most immunologists run clinics, provide advice on the wards and work in the lab.

Page 65: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• The study of inherited aspects of immunity

• Support stem cell and organ transplants

• Usually scientists

Page 66: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Immune disorders can affect the heart e.g. autoimmune anaemia, Grave’s disease, lupus

• Heart transplants could not be performed without careful tissue typing to match the donor and recipient

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•Heart transplants have only become possible with advances in immunology

•The first heart transplant was performed in 1967

•It takes up to 10 hours to perform a heart transplant

•People have survived over 20 years following heart transplants

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• The study of diseases of fetuses and babies

• Paediatric pathologists are doctors

• They perform post mortems to find out why babies have died

• They also diagnose diseases in babies and children

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• Paediatric pathologists provide information about heart defects

• This helps families plan future pregnancies

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The investigation of suspicious deaths

•Perform post mortems to find out how people died

•The most high profile of all pathology specialties but accounts for less than 1% of pathologists in the UK

Page 71: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• As well as performing autopsies, forensic pathologists give evidence in court and give advice to families, police and lawyers

• Often investigate sudden death due to heart disease e.g. distinguishing between death due to drugs, inherited conditions, trauma or disease

Page 72: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

The study of the effects of drugs and chemicals

•Measure levels of drugs in the blood and other body fluids

•May work for industry, in hospitals, with forensic cases or on the environment

Page 73: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Ecstasy can trigger heart attacks, increases heart rate and blood pressure, can cause heart failure

• Heroin lowers blood pressure, can make the heart rate slow and irregular, injection increases risk of heart valve infection, additives can cause blood clots

Page 74: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Pathology as it applies to other animals

• All the different branches of pathology are found in veterinary medicine as well

Page 75: Pathology: the heart of modern healthcare. Broken heart Young at heart With all my heart Heart to heart My heart sank Hand on my heart Queen of

• Animals have heart disease too

• Dogs can have inherited or acquired heart disease, just as humans do

• In dogs the problems are often with the heart valves or muscle

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•Cardiomyopathies are common in cats, particularly hypertrophic cardiomyopathy

•Cats and dogs do not develop coronary heart disease

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Pathology is involved in the

• Prevention• Diagnosis• Treatment• Monitoring

of heart disease

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