Posts Tagged ‘embryology of heart’

The relationship between Aorta & PA is the key to diagnose many complex congenital heart diseases. Here is a simplified illustration for gross understanding. Please refer to other sources for complete review.


Further reading

CONGENITAL HEART DISEASE| VOLUME 118, ISSUE 9P1390-1398, What Determines Whether the Great Arteries Are Normally or Abnormally Related?   https://doi.org/10.1016/j.amjcard.2016.07.050


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Most  cardiologists  are familiar with  “Circulation” . We know  it  is a top  cardiology  journal with highest impact factor.  Few of us are  aware  of  a journal called  “Circulation  research” ( I wonder  why it is named  like that ,  as if  the regular   circulation journal  does  not carry research stuff  !)

It is one of the  path breaking   journals that regularly  churn out state  of  the art , often  mind  boggling research stuff.  Once in while we should get a feel of  basic science  research  as it  happens.

How else we are going to know an  atrial cell is to be bio engineered  shortly to behave like a  SA node  in patients with sinus node dysfunction. (Biological pacing )

This team from academic  medical  centre Amsterdam   should be credited   for  publishing   this gem of  an  article   from  a  study  involving the  measly mice !

It  deals elaborately  about the embryonic basis of AV nodal  disorders  . Specifically it  explains  the genesis of  WPW syndrome and how AV rings get muscularised  .

(It  is  due to   error in  bio-genetic forces ,which  affect the    incorporation  of AV nodal tissue  in the  fibrous  skeleton .This   results  in ectopic  junctional  tissues appear   any where along  the AV ring . This is the basis of  accessory AV pathway and   clinical  re-excitation.)

Final message

Once in a while  we should develop the habit of reading  tough  journals  like circulation research . After all ,   if a cardiologist  is not reading   these stuff who else  . . . will  ?



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Life  is nothing , but the intervening time between the first heart  beat and the last heart beat of an individual  !

Human heart is not an ordinary organ.  Right from the day 22  of fetal life , when the cardiac jelly  begins to beat till  the early  new-born period ,  (In some, even longer !)  it continues to evolve.

We know  heart as a hemodynamic organ . But ,  in the fetus   it is  dynamic in  a  different sense (Embryo-dynamics) . As the mother’s  heart  takes care of the fetal circulation ,  the fetal heart concentrates  on it ‘s  own growth  .The heart learns the  lessons of life in a hard way  , it has to survive the next 70 -80 years independently .

The complexity is enormous . The cardiac muscle  comes  from  mesenchyme, the conducting system  comes from ectoderm .Systematic  events  like , looping  , partition  , regression  of the heart tube should occur at critical times .  Apart from this , the venous and arterial  connections ( Aorta IVC,SVC)  develop concomitantly and has to fuse with respective  chambers without any error.

It is a wonderful biological marvel  happening inside every fetus without the help of any architect  !

The changes do not stop at birth. It continues , well  after delivery . One  hole gets closed(PFO), one conduit disappears (PDA) .One chamber regress (RV) . We, expect all these things to happen in a  meticulous and  sequential  way.

Yes , it happens in most. But , in many with altered bio – genetic forces  things   fail to unfold  in  the programmed way.    It is not at all a surprise ,  to find some common aberration .

So , when some body is born  with a congenital heart defect , don’t blame  it on God .He does his job , in billions and billions of heart in the right manner .

It is our ancestral gene  code that gets awry in a few  !

In Hindu  philosophy  the  defects  we inherit  are the wages we pay for our ancestral misdeeds  .

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