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MEDICAL ANIMATION TRANSCRIPT: In the normal heart, deoxygenated blood flows from the body through the superior and inferior vena cava into the right atrium. The blood, a volume known as preload, then moves into the right ventricle, which contracts and sends blood out of the heart and into the lungs to remove carbon dioxide and collect oxygen. Oxygenated blood moves from the lungs into the left atrium, then moves into the left ventricle which contracts and propels oxygenated blood out of the heart and into the systemic circulation against resistance known as after load. When the heart losses its ability to pump enough blood to meet its needs or those of the body, the diagnosis is heart failure. In left-sided heart failure, the left ventricle does not pump an adequate volume of oxygenated blood into the systemic circulation. Left-sided heart failure causes pulmonary congestion, a buildup of blood and fluid in the lung tissues that interferes with respiration. In response to the low levels of oxygen, the heart rate increases to compensate for the left ventricle's weakened state and to meet the body's oxygen demands, which in time leads to thickening, or hypertrophy, of 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. In right-sided heart failure, the right ventricle is unable to contract with enough force to drive enough blood through the pulmonary arteries to the lungs for oxygenation. Right-sided heart failure results in a buildup of blood in the venous circulation, causing fluid retention called edema throughout the body. Deprived of sufficient blood flow, the kidneys fail to filter excessive sodium and water from the blood, leading to a fluid imbalance and increased vascular resistance against which the heart must pump. The result is perpetual damage to the heart's overworked tissues. Treatment for heart failure involves changes in lifestyle such as diet and exercise, medication, surgery, or a combination of approaches. Commonly, therapies for right-sided heart failure are geared toward improving left sided cardiac function. In heart failure, an increase in fluid volume places added stress on the overloaded heart. Diuretic medications reduce fluid volume and venous return by inhibiting sodium and water reabsorption along the kidney's renal tubular system, increasing the amounts of sodium and water excreted in the urine and the volume of urine produced. ACE inhibitors 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 is a medication that increases the force of myocardial contractility by raising intracellular sodium and calcium concentrations. To compensate for the decreased cardiac output in heart failure, the sympathetic nervous system initiates norepinephrine release, raising the overworked heart's rate and force of contractions. Beta-blockers are prescribed to 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]
"Thank you very much for the great work on the medical exhibits. Our trial
resulted in a $16 million verdict for a 9 year old boy with catastrophic
injuries, and the medical illustrations definitely played key role in the
trial."
David Cutt
Brayton Purcell
Salt Lake City, UT
"For us, the defining feature of effective demonstrative evidence is
whether, by itself, the piece will tell the story of the case. Medical legal
Art provides our firm with illustrations and animations that are clear and
persuasive. Their exhibits tell the story in a way that allows the jury to
understand a very complex subject, very quickly."
James D. Horwitz Koskoff, Koskoff & Bieder, P.C. Bridgeport, CT
"I wanted to take some time out to let you know what a wonderful job you did
with the 'collapsed lung/fractured rib' illustrations. They were both
detailed and accurate. My medical expert was comfortable working with them
and he spent at least an hour explaining to the jury the anatomy of the
lungs, the ribs and the injuries depicted in the illustrations. Needless to
say, the jury was riveted to the doctor during his testimony.
The jury returned a verdict for $800,000.00 and I'm sure we would not have
done so well if not for the visualizations we were able to put forth with
your assistance. Lastly, my special thanks to Alice [Senior Medical
Illustrator] who stayed late on Friday night and patiently dealt with my
last minute revisions."
Daniel J. Costello
Proner & Proner
New York, NY
"For modern audiences, it is absolutely essential to use medical
demonstrative evidence to convey the severity and extent of physical
injuries to a jury. Your company's high quality illustrations of our
client's discectomy surgery, combined with strong expert testimony, allowed
the jury to fully appreciate the significance of our client's injuries.
We are very pleased with a verdict exceeding $297,000.00, far in excess of
the $20,000.00 initially offered by the defendant. The medical demonstrative
evidence provided by Medical Legal Art was an asset we could not have
afforded to have been without."
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.
