Calcific aortic stenosis
Degenerative aortic valve stenosis of the elderly characterized by progressive fibroatheromatous calcification of the three aortic cusps that begins at the bases and advances toward the free edges without commissural fusion.
Structural heart conditions
Structural heart pathologies in the 3D cardiac simulator
Explore intracavitary anatomy, hemodynamics, and clinical correlation of 42 valvular, myocardial, and congenital heart diseases in an interactive 3D heart.
The simulator's structural mode represents cardiac anatomy in an open-chamber view with real-time visible structural abnormalities, integrating hemodynamic pressure and flow changes with the 12-lead ECG tracing. The model continuously synchronizes the cardiac cycle with the auscultation of heart sounds and murmurs, jugular venous pulse tracings, and peripheral arterial pulse curves. Each technical sheet details diagnostic criteria and model limitations, including a direct link to open the pathology in the 3D simulator.
Left-sided valves
8 pathologiesAortic stenosis in bicuspid aortic valve
Aortic valve stenosis developing on a congenital bicuspid aortic valve due to chronic abnormal hemodynamic shear stress precipitating premature calcification and stiffness (typically 1–2 decades earlier than in the tricuspid form).
Chronic aortic regurgitation
Chronic valvular aortic regurgitation characterized by progressive volume overload of the left ventricle due to diastolic backflow from the aorta across an incompetent aortic valve.
Rheumatic mitral stenosis
Mitral valve stenosis due to cicatricial sequelae of rheumatic fever, characterized by commissural fusion, thickening and retraction of leaflet free edges, and chordal shortening or fusion.
Degenerative mitral regurgitation (flail P2)
Severe primary organic mitral regurgitation secondary to spontaneous or degenerative chordal rupture (typically of the P2 scallop of the posterior leaflet in the setting of fibroelastic deficiency or myxomatous degeneration).
Acute mitral regurgitation from papillary muscle rupture
Catastrophic acute mitral regurgitation secondary to necrosis and complete or partial mechanical rupture of a papillary muscle (typically the posteromedial papillary muscle in the setting of an acute inferior or inferolateral myocardial infarction).
Mitral valve prolapse (Barlow disease)
Advanced, diffuse form of myxomatous degeneration of the mitral valve apparatus (Barlow disease).
Mitral annular calcification
Chronic non-inflammatory degenerative process characterized by deposition of calcium and lipids in mitral fibrous annulus (predominantly in posterior annulus).
Right-sided valves
4 pathologiesFunctional tricuspid regurgitation
Incompetence of the tricuspid valve secondary to right ventricular dilation and/or tricuspid annular dilation and leaflet tethering, without intrinsic structural alterations of the valve leaflets.
Rheumatic tricuspid stenosis
Tricuspid valve stenosis secondary to chronic rheumatic involvement, characterized by fibrous leaflet thickening, commissural fusion, and chordal shortening restricting diastolic opening excursion of the tricuspid valve.
Valvular pulmonic stenosis (doming)
Congenital stenosis of the pulmonary valve characterized by commissural fusion and systolic dome-like (doming) excursion of thin pliable cusps.
Pulmonic regurgitation
Incompetence of the pulmonary valve resulting in pathological backflow of blood from the pulmonary trunk into the right ventricle during diastole.
Prosthetic valves
2 pathologiesMechanical mitral valve prosthesis
Mitral valve replaced by a normally functioning mechanical prosthesis (pyrolytic bileaflet).
Aortic bioprosthesis
Aortic valve surgically replaced by a normally functioning bioprosthesis (bovine pericardial or porcine biological tissue mounted on a rigid three-strut frame or stentless).
Congenital heart disease
6 pathologiesOstium secundum atrial septal defect
Congenital defect of the interatrial septum located in the region of the fossa ovalis (ostium secundum), resulting from excessive resorption of the septum primum or deficient development of the septum secundum.
Patent foramen ovale
Anatomical persistence of virtual communication between both atria at fossa ovalis level due to failure of complete postnatal fusion between septum primum (valve of fossa ovalis) and septum secundum (limbus of fossa ovalis).
Perimembranous ventricular septal defect
Congenital defect of the interventricular septum located in the membranous portion of the septum, adjacent to the aortic valve and septal leaflet of the tricuspid valve.
Patent ductus arteriosus
Persistence of the fetal vascular structure connecting proximal descending aorta (immediately distal to origin of left subclavian artery) to the roof of main pulmonary artery bifurcation.
Aortic coarctation
Congenital stenosis or luminal narrowing of the thoracic aorta characteristically located in the region of the ductus or ligamentum arteriosum insertion (isthmic area), immediately distal to origin of left subclavian artery.
Ebstein anomaly
Congenital malformation of tricuspid valve and right ventricle characterized by failure of embryological delamination with consequent apical displacement and adherence of septal and posterior tricuspid leaflets to right ventricular myocardium.
Cardiomyopathies
5 pathologiesHypertrophic obstructive cardiomyopathy
Primary genetic cardiomyopathy characterized by left ventricular hypertrophy not explained solely by hemodynamic loading conditions.
Dilated cardiomyopathy
Intrinsic myocardial cardiomyopathy characterized by left ventricular (or biventricular) dilation and global systolic dysfunction with depressed ejection fraction (LVEF < 50%).
Restrictive cardiomyopathy (amyloidosis)
Infiltrative restrictive cardiomyopathy caused by progressive extracellular deposition of insoluble amyloid fibrils (AL light chain or ATTRm/ATTRwt transthyretin) in biventricular and atrial myocardial interstitium.
Arrhythmogenic right ventricular cardiomyopathy
Hereditary genetic cardiomyopathy characterized by progressive fibrofatty replacement of right ventricular free wall myocardium (preferentially in the 'triangle of dysplasia': RVOT, apex, and subtricuspid region).
Takotsubo syndrome
Acute stress cardiomyopathy syndrome characterized by transient and reversible regional left ventricular systolic dysfunction (typically apical and mid-ventricular ballooning with compensatory contractile hyperkinesia of basal segments).
Pericardium
3 pathologiesAcute pericarditis
Acute inflammation of the pericardial sac (duration typically < 4–6 weeks) of infectious (frequently viral or idiopathic), autoimmune, post-pericardiotomy, or uremic etiology.
Cardiac tamponade
Medical emergency and acute or subacute cardiac compression syndrome caused by accumulation of pericardial fluid under tension that elevates intrapericardial pressure above normal intracavitary diastolic pressures, impeding ventricular filling.
Constrictive pericarditis
Chronic fibrocalcific disorder of the pericardial sac in which parietal and visceral pericardial layers fuse into a rigid, thickened, non-compliant shell encircling and constricting the heart.
Infections and inflammation
7 pathologiesMitral infective endocarditis with perforation
Destructive bacterial or fungal infection of the mitral valve characterized by the presence of septic vegetations and tissue perforation or tearing of mitral leaflets.
Aortic infective endocarditis with perforation
Destructive bacterial or fungal infection of the native aortic valve characterized by the proliferation of infected vegetations on the ventricular aspect of aortic cusps, with tissue perforation, cusp laceration, or commissural detachment.
Aortic infective endocarditis with root abscess and fistula to right atrium
Invasive and destructive periannular complication of aortic endocarditis characterized by phlegmonous and abscess extension to the aortic root and fibrous trigone, with transmural erosion and fistula into the right atrium.
Tricuspid infective endocarditis
Infection of the right tricuspid valvular endocardium (predominantly by Staphylococcus aureus in people who inject drugs, central venous catheter carriers, or long-term vascular access lines).
Pacemaker or defibrillator lead in right ventricle
Presence of a transvenous cardiac implantable electronic device (pacemaker or ICD) lead chronically positioned across the tricuspid valve orifice into the right ventricle (apex or interventricular septum).
Myocarditis
Inflammatory disease of the myocardium (most frequently triggered by viral infections such as enterovirus, parvovirus B19, human herpesvirus type 6, adenovirus, or SARS-CoV-2, or mediated by autoimmune processes or drug toxicity) characterized by myocyte infiltration.
Acute rheumatic carditis
Acute inflammatory manifestations of rheumatic fever on cardiac structures, characterized by active valvulitis (predominantly mitral), myocarditis, and variable degrees of pericarditis (rheumatic pancarditis).
Complications of myocardial infarction
3 pathologiesPost-infarction ventricular septal defect
Mechanical complication of transmural acute myocardial infarction characterized by transmural necrosis and rupture of interventricular septum, generating acute left-to-right shunt with biventricular volume overload and cardiogenic shock.
Left ventricular free wall rupture
Catastrophic mechanical complication of transmural acute myocardial infarction characterized by complete rupture of necrosed ventricular myocardium into pericardial space, causing acute tension hemopericardium, severe cardiac tamponade, cardiogenic shock, and electromechanical dissociation.
Left ventricular aneurysm with mural thrombus
Chronic circumscribed deformation and bulging of the left ventricular wall (true aneurysm) as a sequela of a previous transmural myocardial infarction.
Masses and tumors
4 pathologiesLeft atrial myxoma
Most frequent primary benign cardiac neoplasm in adults, located predominantly in left atrium and attached by a mobile stalk to interatrial septum at fossa ovalis.
Cardiac rhabdomyoma
Most common primary cardiac tumor in neonates and children, of benign hamartomatous nature, characterized by myocardial accumulations of glycogen-rich vacuolated cardiomyocytes, closely linked to tuberous sclerosis complex.
Epicardial metastases with effusion
Secondary neoplastic involvement of the heart produced by dissemination of extracardiac primary malignant tumors.
Left atrial appendage thrombus
Formation of a mural or mobile thrombus within fundus of left atrial appendage (LAA), caused by critical atrial blood stasis, endothelial dysfunction, and loss of active mechanical contractile function in patients with atrial fibrillation.