This animation may only be used in support of a single legal proceeding and for no other purpose. Read our License Agreement for details. To license this image for other purposes, click here.
MEDICAL ANIMATION TRANSCRIPT: In left-sided heart failure, the left ventricle cannot pump an adequate amount of blood, a volume known as preload, out of the heart. This condition causes pulmonary congestion, a build up of blood in the pulmonary vessels causes fluid in lung tissues that impedes normal respiration. Systolic left-sided heart failure describes the left ventricle's inability to contract with enough force to drive blood out of the heart against resistance called afterload to the rest of the body. After a left ventricular contraction, the blood left behind in the chamber causes blood to back up into the left atrium and pulmonary circulation, leading to pulmonary congestion. Diastolic left-sided heart failure describes the inability of the left ventricle to expand sufficiently to accommodate oxygenated blood entering from the left atrium. In this condition, the left ventricle contracts with normal force, but the blood volume that is pumped out is insufficient to meet the body's needs. Long standing diseases such as coronary artery disease, hypertension, and diabetes can thicken and stiffen the ventricular muscle, making it a non-compliant, inefficient pump. As a result of reduced myocardial contractility, the unexpelled blood pools inside the left ventricle, and the chamber expands to hypertrophic size. This hypertrophy of the heart muscle results in the insufficient delivery of nutrients and oxygen to tissues. In both systolic and diastolic left-sided heart failure, the build up of unexpelled blood increases pressure in the pulmonary circulation causing serosanguineous fluid to seep into the alveoli and interstitium. This fluid build up is heard as crackles and rhonchi when the lungs are auscultated. As the lungs saturate with fluid, patients may develop difficulty of breathing called dyspnea, trouble breathing while lying flat called orthopnea, or rapid breathing called tachypnea. The heart rate increases to compensate for the left ventricles weakened state, which in time leads to thickening the myocardium as it labors to push blood out of the heart against the increasing pressure in the pulmonary vessels and fluid in the lungs and continuing the cycle of cardiac muscle damage. Treatment for heart failure involves changes in lifestyle such as diet and exercise, medication, surgery, or a combination of approaches. Medications commonly prescribed for heart failure include diuretics, which reduce fluid volume and venous return by inhibiting sodium and water reabsorption along the kidney's renal tubular system, ACE inhibitors, which block hormones in the renin-angiotensin aldosterone system, dilating vessels, lowering blood volume and venous return, decreasing the heart's workload, and halting ventricular hypertrophy, digoxin, a cardiac glycoside medication that increases the force of myocardial contractility by raising intracellular sodium and calcium concentrations, and beta-blockers, which compete with norepinephrine molecules for binding sites on cardiomyocytes, preventing norepinephrine's effects, resulting in reduced speed and strength of the contractions, which can support more efficient circulation through the body. ♪ [music] ♪
"Whether it's demonstrating a rotator cuff tear, neck movement a few
milliseconds after rear impact, or a proposed lumbar fusion, the Doe Report
represents an instant on-line database of medical illustration for
health-care and legal professionals.
Illustrations can be purchased 'as is' or modified within hours and sent
either electronically or mounted on posterboard. An illustration is worth a
thousand words, as juries perk up and look intently to capture concepts
that are otherwise too abstract. Start with good illustrations, a clear and
direct voice, a view of the jury as 12 medical students on day one of
training, and your expert testimony becomes a pleasure, even on cross
examination. An experienced trial lawyer should also emphasize these
illustrations at the end of trial, as a means of visually reinforcing key
concepts covered.
As a treating physician, I also use these accurate illustrations to educate
my own patients about their medical conditions. The Doe Report is an
invaluable resource, and its authors at MLA have always been a pleasure to
work with."
Richard E. Seroussi M.D., M.Sc.
Diplomate, American Boards of Electrodiagnostic Medicine and PM&R
Seattle Spine & Rehabilitation Medicine
www.seattlespine.info
"We are extremely pleased with the quality of the medical exhibits and the
timely manner in which they were provided. I will certainly recommend
your company to my business associates who could benefit from your services.
Please tell Brian Wilson [Director of Content Development, Senior Medical
Illustrator] that he did an exceptional job on these exhibits."
K. Henderson
Dunaway and Associates
Anderson, SC
"This past year, your company prepared three medical illustrations for our cases; two in which we received six figure awards; one in which we received a substantial seven figure award. I believe in large part, the amounts obtained were due to the vivid illustrations of my clients' injuries and the impact on the finder of fact."
Donald W. Marcari Marcari Russotto & Spencer, P.C. Chesapeake, VA
"I have found that the personalized medical illustrations prepared by Medical
Legal Art have been very accurate and helpful. The medical doctors, both
treating physicians and expert witnesses, have commented on the accuracy and
professionalism of the medical illustrations. Most importantly, your prompt
service and attention upon even short notice has been tremendous. I can
certainly say that the medical illustrations prepared by Medical Legal Art
have assisted us in bringing cases to a successful resolution."
Paul L. Redfearn
The Redfearn Law Firm, P.C.
Kansas City, MO
Medical Legal Art creates medical demonstrative evidence (medical
illustrations, drawings, pictures, graphics, charts, medical animations,
anatomical models, and interactive presentations) for use during legal
proceedings, including research, demand letters, client conferences,
depositions, arbitrations, mediations, settlement conferences, mock jury
trials and for use in the courtroom. We do not provide legal or medical
advice. If you have legal questions, you should find a lawyer with whom you
can discuss your case issues. If you have medical questions, you should seek the advice of a healthcare provider.