Endocardium

The endocardium is the innermost layer of the heart wall. For endocardium including the four heart valves.

Anatomy

The endocardium is the innermost of the three layers of the heart wall. It consists of endothelium and connective tissue about 0.5-1.0 mm thick, and may itself be divided into the following histological layers (from inner to outside):

  • The endothelium, which is formed by a continuous single layer squamous epithelium.
  • The stratum subendothelial that consists of loose connective tissue with sparse elastic fibers.
  • The stratum myoelasticum further divisible into the internal elastic lamina, lamina muscularis externa and lamina fibroelastica. This layer is, as the name suggests, smooth muscle and abundant collagen fibers. For this purpose, you can also find isolated blood vessels and nerve fibers.
  • Tela the subendocardialis is a loose connective tissue layer in the Purkinje fibers are also included.

The endocardium covers the entire lumen - the papillary muscles and chordae ( here, however, lacks the Tela subendocardialis ) - and forms the four heart valves: the mitral valve, tricuspid valve, aortic valve and pulmonary valve.

Function

With its smooth surface prevents the endocardium that the blood from sticking to the heart wall and forms clots. In addition, the smooth surface makes the blood flow more evenly and work of the heart efficiently. Even small bumps, eg after an infection ( endocarditis), interfere with this clean blood flow and can lead to restriction of the cardiac output.

The heart valves act as mechanical valves, forcing blood flow in one direction. Thus, for example, prevents the mitral valve, which is closed in systole, the return of blood from the left ventricle into the left atrium when the heart muscle contracts.

Diagnostics

One can see the endocardium as a very thin bright layer in echocardiography. The heart valves can be presented and examine very well by echocardiography. Using TEE can increase the recognition of details echocardiography again.

When suspected endocarditis blood tests are very important.

  • Inflammatory markers (leukocytes, CRP)
  • Multiple blood cultures

Diseases

Inflammatory changes in the area of the endocardium are called endocarditis. In veterinary medicine, which often occur in animals primarily degenerative changes of the endocardium are called Endokardiosen, which may also occur as a consequence of endocarditis.

In humans, bacterial endocarditis is usually caused by streptococcus or other bacteria that are flushed from other non -healed infections. The main complication here is the involvement of the heart valves, which can lead to a massive reduction in cardiac output. These can be drawn from a valvular insufficiency of all four flaps to heart failure, which is heavier, depending on the restriction of the flaps.

Other diseases of endocardium and the valves:

  • Rheumatic endocarditis
  • Endocardial fibroelastosis
  • Endomyokardfibrose
  • Carcinoid endocardial fibrosis associated
  • Arteriosclerosis of the heart valves in particular the aortic and mitral valve
  • Anular calcification
  • Mitral valve prolapse
C-reactive protein Complication (medicine)
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