Tortuous aorta vs normal aorta

The aorta is the main artery of the body that exits the heart and delivers blood to every organ of our body. A tortuous aorta is a twisting or distortion of the aorta that brings on the narrowing or constriction of that vessel, which can cause blood flow to be blocked. This condition, although not immediately life-threatening, can lead to high ...

Tortuous aorta vs normal aorta. The aorta is the main artery of the body that exits the heart and delivers blood to every organ of our body. A tortuous aorta is a twisting or distortion of the aorta that brings on the narrowing or constriction of that vessel, which can cause blood flow to be blocked. This condition, although not immediately life-threatening, can lead to high ...

When a weak area of your thoracic aorta expands or bulges, it is called a thoracic aortic aneurysm (TAA). Approximately 25 percent of aortic aneurysms occur in the chest and the rest occur in the abdomen. Thoracic aneurysms affect approximately 15,000 people in the United States each year. TAAs are serious health risks because they can burst or ...

Dizziness or lightheadedness. Rapid heart rate. Sudden, severe chest pain, abdominal pain or back pain. Finding an aortic aneurysm before it ruptures offers your best chance of recovery. As an aortic aneurysm grows, you might notice symptoms including: Difficulty breathing or shortness of breath.In general, if the diameter of the aneurysm is more than 1.5 times the size of the normal aorta, it is called an aneurysm, an abnormal bulge in the wall of the aorta. Ballooning or bulging of the aortic artery (aneurysm) can develop anywhere along your aorta though most occur in the section running through your abdomen and in the section that ...The descending thoracic aorta (DTA) was analyzed and was divided into four zones of equal length. Subjects were divided into three groups based on their maximum tortuosity value: low (< 30°), moderate (30° - 60°) and high (> 60°). A linear regression model was built to test the effect of age and gender on tortuosity.Higher amounts of calcium were associated with an enlarged, unfolded, less tapered and more tortuous aorta. ... normal distribution. ... Men with thoracic aorta ...Note that 3 cm is derived from the assumption that the normal adult abdominal aortic diameter is approximately 2 cm. ... Note that the aorta becomes increasingly tortuous as people age. Sometimes, the sidewall of a tortuous aorta can appear similar to an intraluminal clot. This is further reason to image the aorta in two …

Tortuosity may affect virtually any arterial bed, from small size vessels, such as subungual capillaries and retinal arteries to middle and large size arteries, such as the coronary, cerebrovascular or iliac vessels, as well as the aorta itself.The aorta tapers distally, with the normal descending aorta always smaller in caliber than the ascending aorta in healthy individuals. The proximal descending aorta is considered abnormal when it exceeds 2.63 cm, and the distal descending aorta is considered abnormal when it exceeds 2.43 cm in diameter [ 7 , 8 ].CT can detect this condition by showing loss of the normal fat plane between the aorta and duodenum and the presence of air in the aorta . Elective surgical repair has been recommended for ascending aortic aneurysms of 5.0–5.5 cm in diameter and descending aortic aneurysms of 5.5–6.5 cm [ 41 ].The aorta, the great artery, is the largest artery of the human body and carries oxygenated blood ejected from the left ventricle to the systemic circulation. It is divided into: thoracic aorta. ascending aorta. aortic arch.Aortoiliac occlusive disease refers to narrowing or blockages in your lower aorta and iliac arteries. Atherosclerosis is the most common cause. Symptoms include leg pain during exercise and erectile dysfunction. Your provider may recommend lifestyle changes or medications. Some people need surgery or a procedure to help their blood …Ribs demonstrate a normal configuration. Vascular tortuosity. Under the category of large vessel involvement, most striking observations are noted in the tortuosity and dilatation of the aortic arch. ... Coronal CT image shows lateral location of the tortuous aorta (empty arrows) reaching to mid-thoracic cavity. (b) 1-month-old female with ...The Blue line on the right shows a straighter, wider curve,”uncoiled”. It is nothing serious by itself. “Uncoiled Aorta” reflects a change of the silhouette of the thoracic aorta as seen on the X ray. It usually refers to a mild enlargement and straightening of the thoracic aorta on the imaging test. It is an indication of normal aging ...An abdominal aortic aneurysm is an enlarged area in the lower part of the body's main artery, called the aorta. The aorta runs from the heart through the center of the chest and belly area, called the abdomen. The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm that ruptures can cause life-threatening bleeding.

The sclerotic aortic valve is thicker than the normal aortic valve. The sclerotic aortic valve has a more calcified brighter looking appearance on the heart ultrasound scan. Symptoms. Aortic sclerosis is an asymptomatic disease, meaning it has no symptoms. It may be associated with the presence of a mild murmur that is picked up …Jun 23, 2016 · Abstract. At present time, both CT and MRI are valuable techniques in the study of the thoracic aorta. Nowadays, CT represents the most widely employed technique for the study of the thoracic aorta. The new generation CTs show sensitivities up to 100% and specificities of 98-99%. Sixteen and wider row detectors provide isotropic pixels ... The biggest artery is the aorta, running from your chest to your abdomen. If fats, cholesterol, and other substances begin building up inside your arteries, that causes hard lesions, called plaque ...410-955-5000 Maryland. 855-695-4872 Outside of Maryland. +1-410-502-7683 International. Coarctation of the aorta is an abnormal narrowing of the aorta. The aorta is the large blood vessel that exits the heart. Transcatheter repair is a type of procedure that can treat the aorta without the need for open heart surgery.We present a patient with symptomatic aortic stenosis and regurgitation with extremely tortuous aorta, and scoliosis and kyphosis who underwent TAVR. By using ...The aorta is the largest vessel within the human body. It originates from the left ventricle of the heart anterior to the pulmonary artery before arching posteriorly and descending along the posterior mediastinum. It descends to the level of the L4 vertebral body where it bifurcates into the left and right common iliac arteries. It is the main artery …

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4,5 Tortuosity of the AA with a CMT is extremely rare. There is only one case reported in the literature in which a CMT with a tortuous upper abdominal aorta ...The aorta is the largest vessel within the human body. It originates from the left ventricle of the heart anterior to the pulmonary artery before arching posteriorly and descending along the posterior mediastinum. It descends to the level of the L4 vertebral body where it bifurcates into the left and right common iliac arteries. It is the main artery in the body and distributes oxygenated ...We present a patient with symptomatic aortic stenosis and regurgitation with extremely tortuous aorta, and scoliosis and kyphosis who underwent TAVR. By using ...At the level of the abdominal aorta (which has a normal diameter of 12–20 mm), a maximum transverse diameter of 25 mm may be considered pathological. The abdominal segment is the portion most frequently affected by the aneurysm (70% of all cases). The etiology is multifactorial, but a predominant role is played by atherosclerosis.There are lots of arteries that are subjected to a build-up of plaque throughout the human lifetime. Atherosclerosis of the aorta affects the large artery in the abdomen called the...Arterial tortuosity syndrome (ATS) is characterized by widespread elongation and tortuosity of the aorta and mid-sized arteries …

Aorta length increases heterogeneously 16,49 with age as quantified by CT 38,50 and MRI. 13,49 The tortuosity of the descending aorta, 37, 51 but not of the aortic arch, 52 increases with aging ...Thoracic aorta. The thoracic aorta begins where the left ventricle ends at the aortic valve and continues down through the chest. A weakening of the artery wall in this region is called a thoracic aortic aneurysm. A healthy aorta is about 1 inch (2.5 centimeters [cm]) wide, or about the diameter of a garden hose.Not related: THe two problems are not related. A tortuous aorta tht is not enlarged significantly is not a great concern. In general there is nothing to worry about if the aortic diameter is less than 5 cm and intervention in the chest is not recommended in most cases unless diameter of 5.5-6 cm NO dilation no worryObjective Tortuosity in the descending thoracic aorta (DTA) comes with aging and increases the risk of endoleaks after TEVAR. With this report, we would like to define and classify tortuosity in the DTA of patients with thoracic aortic disease. Methods Retrospective case–control study of two hundred seven patients, comparing sixty-nine …Aorta length increases heterogeneously 16,49 with age as quantified by CT 38,50 and MRI. 13,49 The tortuosity of the descending aorta, 37, 51 but not of the aortic arch, 52 increases with aging ... Thoracic Aortic Aneurysms. Thoracic aneurysms may involve one or more aortic segments (aortic root, ascending aorta, arch, or descending aorta) and are classified accordingly ( Figure 1 ). Sixty percent of thoracic aortic aneurysms involve the aortic root and/or ascending aorta, 40% involve the descending aorta, 10% involve the arch, and 10% ... Arterial tortuosity syndrome (ATS) is characterized by widespread elongation and tortuosity of the aorta and mid-sized arteries …A thoracic aortic aneurysm occurs in the part of the aorta that runs through the chest. Aneurysms occur more often in the part of the aorta that runs through the belly or abdomen (abdominal aortic aneurysm). Once formed, an aneurysm will slowly get larger and weaker. Treatment may include surgery to fix or remove the aneurysm.An abdominal aortic aneurysm is an enlarged area in the lower part of the body's main artery, called the aorta. The aorta runs from the heart through the center of the chest and belly area, called the abdomen. The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm that ruptures can cause life-threatening bleeding.The risk also is increased for an aortic or other blood vessel dissection or rupture. Bicuspid aortic valve. Having an aortic valve with two cusps instead of three increases the risk of aortic aneurysm. Complications. Tears in the wall of the aorta and rupture of the aorta are the main complications of thoracic aortic aneurysm.

seen in 70% of cases presenting in older children or adults. if the coarctation is distal to either subclavian artery, then increased flow occurs through the subclavian artery, forming a collateral pathway via the internal thoracic artery, anterior intercostal artery, posterior intercostal artery and then into the descending thoracic aorta.

Coarctation of the aorta accounts for approximately 7% of all live births with congenital heart disease and is 1.7 times more common in males. w10 w11 Hypoplasia of the aortic arch to various degrees is a common accompanying feature. w12 There is a significant association with other cardiac lesions (ventricular septal defect, patent arterial duct, and …The location and shape of the aortic root dilatation may provide clues to the aetiology of the ascending aortic aneurysm. The aorta in Marfan syndrome is typically pear‐shaped, being largest at the sinuses of Valsalva, with the ascending aorta tapering to normal calibre at the origin of the innominate artery (fig 3 3).). Aortic aneurysm in ...We are never going back to the days where venture capital firms can win by being the only term sheet on the table. Though this may be a tough pill for some investors, we are never ...The Blue line on the right shows a straighter, wider curve,”uncoiled”. It is nothing serious by itself. “Uncoiled Aorta” reflects a change of the silhouette of the thoracic aorta as seen on the X ray. It usually refers to a mild enlargement and straightening of the thoracic aorta on the imaging test. It is an indication of normal aging ...• Aortic Valve morphology • Normal Aortic size in the adult: –Aoroot < 40 mm –Ascending Ao< 37 mm –Descending Aorta < 28 mm • These values are, however, very variable. 1/9/2018 8 Aortic size to be adjusted ... ‐Tortuous Aorta ‐Frequent follow‐ups ‐Semi‐invasive. 1/9/2018 13 MRIMar 17, 2022 · The aortic arch is the part of the aorta between the ascending aorta and thoracic descending aorta. The sharpness of the angle can be different among individuals. The aortic arch gives rise to three arterial branches: Brachiocephalic artery, which supplies blood flow to the right arm and right carotid artery to the right side of the brain. Not related: THe two problems are not related. A tortuous aorta tht is not enlarged significantly is not a great concern. In general there is nothing to worry about if the aortic diameter is less than 5 cm and intervention in the chest is not recommended in most cases unless diameter of 5.5-6 cm NO dilation no worryAbnormal vascular structures like a severe tortuous thoracic aorta occasionally can be confused with a lung mass or neoplasm. The most common cause of aortic disease mimicking lung mass on CXR is an aortic aneurysm (1). Some cases have reported an intervention or even an operation being performed.Arterial tortuosity syndrome (ATS) is characterized by widespread elongation and tortuosity of the aorta and mid-sized arteries as well as focal stenosis of segments of the pulmonary arteries and/or aorta combined with findings of a generalized connective tissue disorder, which may include soft or doughy hyperextensible skin, joint …

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The aorta tapers distally, with the normal descending aorta always smaller in caliber than the ascending aorta in healthy individuals. The proximal descending aorta is considered abnormal when it exceeds 2.63 cm, and the distal descending aorta is considered abnormal when it exceeds 2.43 cm in diameter [ 7 , 8 ]. Feb 24, 2022 · Aorta. The aorta is a large, cane-shaped vessel that delivers oxygen-rich blood to your body. It starts in the lower-left part of the heart and passes through the chest and abdomen. Along the way, blood vessels branch off the aorta, extending to organs and supporting tissue. Contents Overview Function Anatomy Conditions and Disorders Care. Aortic dissection is a serious condition in which there is a tear in the wall of the major artery carrying blood out of the heart (aorta). As the tear extends along the wall of the...Coarctation of the aorta (CoA) is one of the most common congenital cardiac anomalies causing a narrowing of the proximal descending [ 1, 2] varying within a range of arch abnormalities from a discrete narrowing to a long segment of arch hypoplasia [ 2 ]. It was first described by Thiene [ 3] in 1760 and accounts for 4%-6% of all …The splenic artery (limb of the celiac T toward patient’s left; Fig. 23.2) follows a tortuous course along the posterosuperior margin of the pancreatic body and tail ( Fig. 23.3A) and terminates by splitting into a number of branches in the hilum of the spleen. Along the way, the splenic artery gives rise to several pancreatic branches, short ...The aorta is the largest artery in your body and carries blood from your heart and lungs to everywhere else. Although your aorta is thick and large (running the length of your chest and abdomen ...There is a mild thoracic aorta ectasia, especially in the ascendant and aortic arch, observed as a prominent aortic knob (red circle on frontal x-ray). On the lateral view is possible to follow all the thoracic aortic (red lines) thanks to diffuse parietal atherosclerotic calcifications. The aorta has 3.8 cm in diameter. Heart size is normal.Mar 15, 2022 · The thoraco-abdominal aorta is tortuous. Included abdominal aorta shows dilated and tortuous branches of the coeliac axis. The main pulmonary artery is short with early bifurcation with long tubular configuration and parallel proximal course of the right and left main pulmonary arteries (arrowheads in C). Normal morphology of bilateral ... Celiac Artery. The celiac artery, also called the celiac trunk or celiac axis, is the first major visceral branch of the abdominal aorta ( Fig. 23.1).It arises from the anterior aortic surface, between the diaphragmatic crura. It then bifurcates about 1 to 3 cm from its origin into the common hepatic and splenic arteries, which are readily visualized with … ….

Citation, DOI, disclosures and article data. Right-sided aortic arch is a type of aortic arch variant characterized by the aortic arch coursing to the right of the trachea. Different configurations can be found based on the supra-aortic branching patterns, with the two most common patterns being the right-sided aortic arch with mirror image ...If an aneurysm forms between the upper and lower parts of the aorta, it's called a thoracoabdominal aneurysm. A thoracic aneurysm may be round or tube …6 tortuous aorta patients report severe depressed mood (13%) 14 tortuous aorta patients report moderate depressed mood (30%) 17 tortuous aorta patients report mild depressed mood (36%) 9 tortuous aorta patients report no depressed mood (19%)Symptoms. Aortic dissection symptoms may be similar to those of other heart problems, such as a heart attack. Typical signs and symptoms include: Sudden severe chest or upper back pain, often described as a tearing or ripping sensation, that spreads to the neck or down the back. Sudden severe stomach pain. Loss of consciousness.In general, if the diameter of the aneurysm is more than 1.5 times the size of the normal aorta, it is called an aneurysm, an abnormal bulge in the wall of the aorta. Ballooning or bulging of the aortic artery (aneurysm) can develop anywhere along your aorta though most occur in the section running through your abdomen and in the section that ...Abdominal aortic aneurysm treatment options may include: Endovascular repair. This treatment is most often used to repair an abdominal aortic aneurysm. A surgeon inserts a thin, flexible tube, called a catheter, through an artery in the groin area and guides it to the aorta. A metal mesh tube on the end of the catheter is placed at the site of ...seen in 70% of cases presenting in older children or adults. if the coarctation is distal to either subclavian artery, then increased flow occurs through the subclavian artery, forming a collateral pathway via the internal thoracic artery, anterior intercostal artery, posterior intercostal artery and then into the descending thoracic aorta.When aortic aneurysms are found incidentally, it is advisable to seek a cardiothoracic opinion when the ascending and descending aortas are more than 4.5 and 5.5 cm, respectively, in diameter so that appropriate monitoring can be instituted. Normal growth rate of all types of thoracic aneurysms averages 0.12 cm per year . Tortuous aorta vs normal aorta, Aside from tortuous aorta chest radiograph is normal. The barium study shows a narrowed lumen (arrows) on AP view and flattened lumen on lateral view (arrowheads) suggestive of a intramural hematoma. ... Tortuous aorta A tortous descending aorta is a common cause of extrinsic impression on the esophagus., The sclerotic aortic valve is thicker than the normal aortic valve. The sclerotic aortic valve has a more calcified brighter looking appearance on the heart ultrasound scan. Symptoms. Aortic sclerosis is an asymptomatic disease, meaning it has no symptoms. It may be associated with the presence of a mild murmur that is picked up …, Atherosclerosis of the aorta is the gradual buildup of plaque in your aorta. It’s a common condition that happens silently over many years. You may not have symptoms until the disease leads to a medical emergency. These include heart attack, stroke or sudden loss of blood flow to your organs and tissues., Apr 25, 2023 · An abdominal aortic aneurysm is an enlarged area in the lower part of the body's main artery, called the aorta. The aorta runs from the heart through the center of the chest and belly area, called the abdomen. The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm that ruptures can cause life-threatening bleeding. , 3D aortic segmentations for a representative young subject (panel a) and an old subject (panel b). A more tortuous aorta can be seen in the old subject. Panel a also shows the four aortic segments used for regional analysis in this study: ascending aorta (AAo), descending aorta (DAo), suprarenal and infrarenal abdominal aorta (SAA and IAA)., BackgroundIncreased vascular tortuosity is a hallmark of ageing of the vascular system, including the aorta. However, the impact of tortuosity on aortic blood flow is unknown. We hypothesized that increased tortuosity would be associated with increased blood flow helicity and with decreased degree of blood flow turbulence as measured by …, Anterior aortic sinus: occupies the space between the wall of the aorta and the right cusp of the aortic valve. ... An aortic aneurysm is diagnosed when the increase in aortic wall diameter is 1.5 times more than its normal size. Since the normal diameter of the ascending aorta amounts to about 3.5 cm, and 2.5 cm for the abdominal aorta, the ..., These deposits can cause the valve opening to become narrow. Severe narrowing can reduce blood flow through the aortic valve — a condition called aortic valve stenosis. Aortic valve calcification may be an early sign of heart disease, even if there aren't any other heart disease symptoms. Calcification and stenosis generally affect …, At 70 yrs old I had an aortic aneurysm and a quadruple by-pass. Left the hospital two days early. They said it was a first. Was not crazy about the hospital, but the surgeon was great. I was in good physical condition going in. Started rehab two weeks later in better condition than most that left rehab three weeks later., 10 Aug 2016 ... ... aorta and a large aneurysm via CT scan, compared to what is actually seen in the body during surgery, and compare it to a post-surgery view., Aortic atheroma refers to plaque that builds up in your aorta. This condition is called atherosclerosis of the aorta. Your aorta is the largest artery in your body. It extends upward from your heart and then curves downward through your chest and belly. Plaque buildup in your aorta raises your risk of many conditions, including: Aortic …, Thoracic Aortic Aneurysms. Thoracic aneurysms may involve one or more aortic segments (aortic root, ascending aorta, arch, or descending aorta) and are classified accordingly ( Figure 1 ). Sixty percent of thoracic …, The location and shape of the aortic root dilatation may provide clues to the aetiology of the ascending aortic aneurysm. The aorta in Marfan syndrome is typically pear‐shaped, being largest at the sinuses of Valsalva, with the ascending aorta tapering to normal calibre at the origin of the innominate artery (fig 3 3).). Aortic aneurysm in ..., In some health conditions, the arteries in the heart may be twisted. The heart arteries are called the coronary arteries. Twisted arteries also are called tortuous arteries. There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit ..., CT can detect this condition by showing loss of the normal fat plane between the aorta and duodenum and the presence of air in the aorta . Elective surgical repair has been recommended for ascending aortic aneurysms of 5.0–5.5 cm in diameter and descending aortic aneurysms of 5.5–6.5 cm [ 41 ]., Computed tomography (CT) of the chest demonstrated an enlarged, tortuous aorta (Fig. 2). The diameters of the ascending thoracic aorta, the descending thoracic aorta, and the proximal abdominal aorta were 7 cm, 6 cm, and 5.3 cm, respectively. There was an intramural thrombus at the level of the descending aorta., Many radiologists use “ectatic” rather than “dilated” to describe a mildly enlarged aorta, whereas others use “ectatic” to describe an abnormal aortic shape, such as a “tortuous” aorta. 7 Even more problematic is the fact that some imaging groups use …, The aorta is the largest artery in the body. It carries oxygen-filled blood from the heart to different organs in the body. The aorta starts at the heart’s left ventricle, arches upwards towards the neck, then curves back downward, extending into the abdomen. Learn more about the important role the aorta plays in the body., Most aortic aneurysms occur in the infrarenal segment (95%). The average size for an infrarenal aorta is 2 cm; therefore, AAAs are usually defined by diameters greater than 3 cm. The normal size for the thoracic and thoracoabdominal aorta is larger than that of the infrarenal aorta, and aneurysmal degeneration in these areas is defined …, An abnormal tortuous course of aortic arch may be seen in a cervical aortic arch where the aorta runs into the upper mediastinum which is distant from the course of pulmonary artery. (9) Connection between both great vessels—this may be found in Aortopulmonary window. ... In five chamber view normal ascending aorta normal or …, 10 Aug 2016 ... ... aorta and a large aneurysm via CT scan, compared to what is actually seen in the body during surgery, and compare it to a post-surgery view., Results. Tortuosity and helicity were higher whereas TKE, velocity, and Reynolds number were lower in Old than in Young, for all aortic regions (p < 0.05) except for helicity in the descending aorta.Tortuosity correlated positively with helicity and negatively with TKE for all aortic regions (Spearman rho=±0.45–±0.72, p < =0.002) …, Sep 30, 2015 · Ectasia and tortuosity are commonly seen throughout the body and in certain disease states. Diameter: Aneurysm 2x normal size of native aorta. Tortuous regards to the course of the vessel. Ectasia refers to enlarged vessel but less than twice normal. Arteriomegaly-large arteries, not aneurysmal. , Not related: THe two problems are not related. A tortuous aorta tht is not enlarged significantly is not a great concern. In general there is nothing to worry about if the aortic diameter is less than 5 cm and intervention in the chest is not recommended in most cases unless diameter of 5.5-6 cm NO dilation no worry, Indices Commodities Currencies Stocks, An aortic aneurysm is a weakened or bulging area on the wall of the aorta, which may occur anywhere along its length. Aortic aneurysms can cause two problems: Rupture: The weakened or ballooned area may develop a hole, called a rupture, that allows blood to burst out into the body. Dissection: The blood pumped forcefully through the aorta can ..., Mar 15, 2022 · The thoraco-abdominal aorta is tortuous. Included abdominal aorta shows dilated and tortuous branches of the coeliac axis. The main pulmonary artery is short with early bifurcation with long tubular configuration and parallel proximal course of the right and left main pulmonary arteries (arrowheads in C). Normal morphology of bilateral ... , The aorta, the great artery, is the largest artery of the human body and carries oxygenated blood ejected from the left ventricle to the systemic circulation. It is divided into: thoracic aorta. ascending aorta. aortic arch., An abdominal aortic aneurysm is an enlarged area in the lower part of the body's main artery, called the aorta. The aorta runs from the heart through the center of the chest and belly area, called the abdomen. The aorta is the largest blood vessel in the body. An abdominal aortic aneurysm that ruptures can cause life-threatening bleeding., Aortic unfolding. ‘Unfolding’ of the aorta – a common X-ray finding in elderly patients – is a phenomenon which arises due to elongation of the ascending aorta with age. It is not usually considered a pathological …, Indices Commodities Currencies Stocks, Variant anatomy of the aortic arch occurs when there is failure of normal aortic development.It results in a number of heterogenous anomalies of the aorta and its branch vessels. Gross anatomy. Normally, the aorta ascends in the superior mediastinum to the level of the sternal notch before arching posteriorly and descending in the left …, The aorta is a large blood vessel that branches off from the heart and pumps oxygen-rich blood back into the body. The aorta carries blood away from the left ventricle and circulat...