Transcript The Cardiovascular System

The
Cardiovascular System
& Cardiovascular
Emergencies
Supplies oxygenated blood to
all cells in the body!!
Components
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Heart – pumps blood
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Vessels – Arteries carry blood
away from the heart and veins
carry blood back to the heart
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Blood – fluid that carries nutrients
essential to cell function
The Heart
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Located in the thoracic cavity
2nd intercostal space at right sternal
border
 5th intercostal space at left
midclavicular line
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about size of your clenched fist
 In mediastinum
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The Heart
4 chambers
 “2 sided” - divided by septum
 2 upper called atria
 2 lower called ventricles
 surrounded by pericardium
 system of one way valves
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Path of blood flow (Systemic
circulation)
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left ventricle
aorta
arteries, arterioles, capillaries, etc ...
Vena cava (superior and inferior)
Right atrium
Path of blood flow (Pulmonary
circulation)
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right ventricle
pulmonary artery
lung ( pulmonary capillaries)
Pulmonary veins
Left atrium
The Circulatory System
Blood Flow Through the Heart
The Heart
 Electrical
System
 independent
 stimulates
contractions of heart
 normally initiated in right atrium
 if initiated from other areas =
abnormal
Electrical Conduction
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Sinoatrial (SA) node
Atrioventricular node
Bundle of His
(AV bundle)
Bundle branches
Purkinje fibers
Vessels
Arteries
 Arterioles
 Capillaries
 Veinioles
 Veins
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Vessels
Vasoconstriction
Effect on Blood Pressure?
Vasodilation
Effect on Blood Pressure?
Major Arteries and Veins
• Aorta
• Pulmonary
• Carotid
• Femoral
• Brachial
• Radial
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Superior vena cava
Inferior vena cava
Pulmonary
Look Up in TEXT!
coronary arteries – Supply
blood to heart muscle itself
The two main
coronary arteries have
openings immediately
above the aortic valve
at the beginning of the
aorta where the
pressures are highest
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Blood
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Liquid Portion - Plasma
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Solid Portion
Red blood cells
 White blood cells
 Platelets
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Blood
Plasma - transports solids
It is basically a salt solution
Blood
Red Blood cells - carry oxygen
AKA - Erythrocytes
Hemoglobin is the substance that
combines with oxygen in a red blood
cell
Blood
White Blood cells - fight infection
AKA Leukocytes
almost all blood cells (red or white)
are made in the bone marrow.
Blood
Platelets – are essential for formation
of blood clots. They perform
coagulation.
AKA - thrombocytes
average amount of blood
in an adult is 4-6 liters.
note
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Systemic Vs pulmonary circulation
Pulmonary artery
Pulmonary vein
Coronary arteries
Pericardium
Myocardium
 If
the cardiovascular system is
working as it should ...
You get…Perfusion
– Adequate flow of
blood through body tissue or
organs to meet the needs of the
cell.
 Definition
Cardiovascular Emergencies
Abnormal Heart Conditions
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Angina Pectoris
Myocardial Infarction
Congestive Heart Failure
Angina Pectoris
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Decreased blood flow to heart muscle results in
ischemia- lack of oxygen
Causes mild to moderate pain
Pain may radiate
Usually lasts 3-8 minutes (rarely longer than 15
mins)
IT GOES AWAY with no permanent damage to
heart muscle
Can be difficult to differentiate from heart attack
Acute Myocardial Infarction
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decreased flow of blood to the myocardium
leading to death of tissue
may not be provoked
moderate to severe pain
Can last between 30 minutes and several hours
May not go away with rest, O2 or nitroglycerin
Immediate transport is essential
AMI
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Signs and Symptoms
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Sudden onset of weakness, nausea, and
diaphoresis
Chest pain or discomfort
dyspnea
irregular pulse
Pain in lower jaw, arms, or back
Sudden fainting
Pulmonary edema
Sudden death
Feeling of impending doom
there are always exceptions ...
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Referred pain
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Atypical pain
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No pain
Congestive Heart Failure
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Causes
 diseased heart valves and
damaged ventricles
 Chronic hypertension
 obstructive pulmonary disease
(emphysema, chronic bronchitis)
 often a complication of an MI
CHF
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Heart tries to compensate.
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Increased heart rate
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Enlarged left ventricle
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The heart can not efficiently pump the amount of
fluid in the body and CHF develops
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Fluid backs up into lungs or body as heart fails
to pump
Signs & Symptoms of CHF
Pedal edema
 JVD
 Ascites
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Critical CHF & Pulmonary Edema
dyspnea
 rales & audible rales
 pink frothy sputum
 tachycardia
 cyanosis
 anxiety, restlessness
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Vascular emergencies
Atherosclerosis & arteriosclerosis
 Thrombus
 Embolus
 Aneurysm
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Athero/arterio -sclerosis
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build up of fatty deposits & calcium
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causes narrowing of the lumen
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can create rough inner surface that
can lead to clot
Athero/arterio -sclerosis
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Results in:
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restricted blood flow
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high blood pressure
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AMI
Thrombus
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formation of clot and debris in vessels
from plaque
can become large enough to occlude
vessel
partial blockage = distal reduction of O2
complete blockage = distal tissue death
Embolus
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a thrombus that breaks off from vessel
wall.
flows through blood vessels
may partially or completely occlude
smaller artery
occlusion will result in decreased oxygen
to tissue or tissue death
Aneurysm
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is a ballooning out of a weakened section
of an artery
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Possibility of rupture
Ruptured aneurysm
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Is a bursting of an aneurysm
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can result in rapid, life threatening internal
bleeding
Abdominal Aortic Aneurysm
(AAA)
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Signs & Symptoms
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“Tearing” abdominal or back pain
Pulsating mass in midline of abdomen
Unequal femoral pulses
Syncope
AAA Treatment
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Rapid transport
High flow O2
Treat for shock
Other Considerations
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other causes of chest pain
pacemakers
 defibrillator implants
 CABG – coronary artery bypass graft
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RX for all
High flow oxygen
(ventilate patient if needed!)
 Position of comfort
 Rapid transport
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medications
Lasix
 Digoxin
 Lanoxin
 Inderal
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NTG = nitroglycerin
Cerebral Vascular Accidents
AKA
“Stroke”
“Brain Attack”
CVA - Cerebral Vascular Accidents
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sudden change in neurological status
caused by interference with blood supply
to brain
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obstructive
hemorragic
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CVA signs & symptoms
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hypertension
altered mental status
hemiparesis & hemiparalysis
headache, blurred vision
one sided facial droop
aphasia
incontinence
Transient Iscemic Attack
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TIA’s
AKA “mini-stroke”
can have symptoms of CVA
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temporary
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The end
Questions?