Transcript Chapter 11-day 2

CARDIOVASCULAR-DAY 2
CHAPTER 11
HEART ACTIVITY
• CONTROLLED BY AUTONOMIC NERVOUS SYSTEM
• HORMONES
• FLUID BALANCE
• ONLY MUSCLE TISSUE TO CREATE ITS OWN
STIMULATION
ELECTRICAL NODES
• THE HEART IS THE ONLY MUSCLE THAT CAN
STIMULATE ITS OWN CONTRACTIONS
• SINOATRIAL (SA) CELLS IN THE RIGHT ATRIUM
START THE HEART –AKA PACEMAKER
• ATRIOVENTRICULAR (AV) NODE SENDS AN
IMPULSE INTO LOWER PORTIONS OF THE HEART
• AV BUNDLE OR BUNDLE OF HIS STIMULATES THE
PURKINJE FIBERS
• PURKINJE FIBERS CAUSE THE VENTRICLES TO
CONTRACT
BLOOD VESSELS
• VEINS
• CARRIES BLOOD TO THE HEART
• CARRY DEOXYGENATED BLOOD
• EXCEPT FOR PULMONARY
• DARK RED
• ARTERIES
• CARRIES BLOOD AWAY FROM THE HEART
• CARRIES OXYGENATED BLOOD
• EXCEPT FOR PULMONARY
• BRIGHT RED
• CAPILLARIES
• EXCHANGES OXYGEN/CO2/NUTRIENTS
• AVERAGE BLOOD VOLUME IS 5-6 L
• BEATS 86,000 TO 144,000 TIMES EACH DAY
• ALL BLOOD IS CIRCULATED IN ONE
MINUTE
CORONARY ARTERIES
•TWO ARTERIES THAT BRANCH
OFF ASCENDING AORTA
•PROVIDE BLOOD SUPPLY TO
HEART
ASSESSMENT TECHNIQUES
• MEASURING PULSE AND BLOOD PRESSURE
• LISTENING TO HEART SOUNDS
• DETERMINING CARDIAC OUTPUT
• MEASURING MUSCLE ACTIVITY WITH
ELECTROCARDIOGRAPHY
• INSERTING A CARDIAC CATHETER
• USING ECHOCARDIOGRAPHY
7
ASSESSMENT TECHNIQUES (CONT.)
• PULSE
• SURGE OF BLOOD AGAINST THE WALLS OF THE ARTERIES
• EIGHT PULSE POINTS ON THE BODY
• NORMAL PULSE RATE FOR ADULTS IS 60 TO 90 BEATS/MIN
• BLOOD PRESSURE
• FORCE OF BLOOD AGAINST THE WALLS OF THE ARTERIES
• SYSTOLIC PRESSURE
• VENTRICLES OF THE HEART CONTRACT
• DIASTOLIC PRESSURE
• VENTRICLES RELAX
• NORMAL BLOOD PRESSURE
• 120/80 MM HG
• VARIES GREATLY AMONG PEOPLE
8
ASSESSMENT TECHNIQUES (CONT.)
• HEART SOUNDS
• LUB-DUB SOUND OF THE HEART
• RESULTS FROM OPENING AND CLOSING OF THE VALVES
• HEARD THROUGH A STETHOSCOPE
• MURMURS
• ABNORMAL OR EXTRA SOUND
• MAY BE BENIGN OR INDICATE A DISORDER
9
ASSESSMENT TECHNIQUES (CONT.)
• ELECTROCARDIOGRAPHY
• THE PATTERN OF ELECTRICAL ACTIVITY IN HEART CONTRACTIONS IS
MEASURED GRAPHICALLY
• NORMAL AND ABNORMAL HEART ACTIVITIES HAVE CHARACTERISTIC
WAVE PATTERNS
10
EKG
From Grauer K: A practical guide to ECG interpretation, ed 2, St. Louis, 1998, Mosby.
11
DISORDERS OF THE
CARDIOVASCULAR SYSTEM
• CARDIAC ARRHYTHMIA
• DISTURBANCE OF THE HEART’S RHYTHM CAUSED BY A DEFECT IN THE
HEART’S PACEMAKER CELLS OR BY DAMAGE TO HEART TISSUE
• CONGENITAL HEART DISEASE
• A GROUP OF DISORDERS THAT AFFECT ABOUT ONE IN EIGHT NEWBORNS EACH
YEAR IN THE UNITED STATES
12
DISORDERS OF THE
CARDIOVASCULAR SYSTEM (CONT.)
• CARDIOVASCULAR DISEASE
• GENERAL TERM FOR THE COMBINED EFFECTS OF ARTERIOSCLEROSIS AND
ATHEROSCLEROSIS
• CONDITIONS CALLED CORONARY ARTERY DISEASE (CAD)
• CAD MAY MANIFEST AS:
• HEART ATTACK
• PERIPHERAL ARTERY DISEASE (PAD)
• ANGINA
• STROKE
13
DISORDERS OF THE
CARDIOVASCULAR SYSTEM (CONT.)
• CONGESTIVE HEART FAILURE (CHF)
• INABILITY OF THE HEART TO PUMP BLOOD ADEQUATELY TO MEET
THE BODY’S NEEDS
• RIGHT SIDED FAILURE-CAUSED FLUID BUILD UP IN THE BODY,
ESPECIALLY LOWER EXTREMITIES
• LEFT SIDED FAILURE-CAUSES FLUID BUILD UP IN THE LUNGS
• USUALLY CAUSED BY DISEASE IN ANOTHER BODY SYSTEM
• LEADS TO INADEQUATE RESPIRATORY AND KIDNEY FUNCTION
14
DISORDERS OF THE
CARDIOVASCULAR SYSTEM (CONT.)
• HYPERTENSION
• HIGH BLOOD PRESSURE
• PRIMARY HYPERTENSION
• CAUSE OF HYPERTENSION UNKNOWN
• SECONDARY HYPERTENSION
• HYPERTENSION CAUSED BY OTHER CONDITIONS, SUCH AS KIDNEY
DISEASE AND ADRENAL DISORDERS
15
DISORDERS OF THE
CARDIOVASCULAR SYSTEM (CONT.)
• MYOCARDIAL INFARCTION
• AKA HEART ATTACK
• RESULTS FROM BLOCKAGE OF THE BLOOD VESSELS TO THE HEART
BY A CLOT (EMBOLISM)
• CARDIAC ARREST
• OCCURS WHEN LARGE AREA OF THE HEART IS AFFECTED AND MAY STOP
FUNCTIONING
16
ISSUES AND INNOVATIONS
• HEART REPLACEMENT AND TRANSPLANTS
• 1967: FIRST HEART REPLACEMENT
• APPROXIMATELY 2000 HEART TRANSPLANTATIONS ARE PERFORMED
EACH YEAR IN THE UNITED STATES
• FIRST ARTIFICIAL HEART, THE JARVIK-7, WAS CONNECTED TO AN
EXTERNAL POWER SOURCE AND PUMP
• 2001: ABIOCOR SELF-CONTAINED ARTIFICIAL HEART
• DESIGNED TO EXTEND LIFE FOR PEOPLE WITH END-STAGE HEART
FAILURE WHO HAD NO OTHER CLINICAL OPTIONS
• HELPS PROVIDES A GOOD QUALITY OF LIFE
17
ISSUES AND INNOVATIONS (CONT.)
Courtesy ABIOMED, Inc., Danvers, Mass.
18
ISSUES AND INNOVATIONS (CONT.)
• THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) APPROVED USE
OF THE SYNCARDIA TEMPORARY TOTAL ARTIFICIAL HEART IN 2005
• USED IN PATIENTS WITH IRREVERSIBLE FAILURE OF THE VENTRICLES
• DESIGNED TO SUPPORT LIFE FUNCTIONS UNTIL A TRANSPLANT
BECOMES AVAILABLE
• IN 2014, THE 1300TH IMPLANT OF THE SYNCARDIA TOTAL
ARTIFICIAL HEART WAS PERFORMED
19