Cardio

Pericardium

myocardium

• endocardium
• forms the 4 chamber separating valves

tricuspid

mitral bicuspid

• L ventricle and aorta
• semilunar

right ventricle and pulmonary artery

atrial depolarization and contraction

Ventricular depolarization and contraction

• Ventricular re-polarization and relaxation
• recovery phase

• pacemaker of heart
• WNL 60-70 BPM

backs up SA node

• infarction
• systemic electrolyte imbalances

pacemaker

Defibrillator

• Medulla
• Detect BP changes

• block SNS stimulation
• block (stop) any increase in rate/force of contraction

• Increase temp
• Increase environmental temp/high humidity
• Exercise
• Smoking
• Stress
• SNS stimulation
• dehydration
• caffinee

Atria relax-> Pressure in atria open AV valves-> blood enters ventricles-> conduction stimulates atrial muscle to expel any remaining blood to ventricles-> atria relaxes-> ventricles begin to contract-> av valve closes-> semilunar valves open-> blood enters pulmonary artery and aorta-> atria begin to fill as ventricles relax

Closure of valves

• defective valves that leak or don't open fully
• turbulence in flow makes sound

volume of blood from ventricle in one min. CO=HRxSV

increase

increases

• cardiac output= (heart rate) x (stroke volume)
• HR= number of ventricle contractions each minute
• SV= amount of blood ejected from each ventricle with each contraction

• HR- SNS, epinephrine
• SV- Venous return (preload), blood volume, SNS, peripheral resistance (after load)

100-120/60-75

Diastole-Systole

• CO and peripheral resistance 
• Venous return (preload)
• HR
• force of contraction of ventricles
• peripheral return/resistance (afterload)
• elasticity of arteries

• constric/dilation of arterioles
• -increase sns= vasoconstriction
• -decrease sns= vasodilation
• blood vessel obstruction

• info sent to medulla
• blood flow adjusted to maintain normal BP ie rising from supine
• SNS, epinephrine- Increase HR and force of contraction

valve abnormalities

• bike, step, treadmill
• assess CV function and arrhythmias
• used in fitness clubs/cardiac rehab program

• coronary
• peripheral

• check on O2 level
• acid base balance

• Angina pectoris
• MI
• May lead to HF, arrhytmia, or suddent death
• Not enough O2 for needs of heart

• changes of small arteries/arterioles (loss of elasticity and walls thick and hard)
• lumen narrows
• leads to ischemia/necrosis of kidneys, brain, and/or heart

• plaques- lipids, cells, fibrin, and debris
• associated with thrombi
• primarily in large arteries
• often starts from an injury to artery when very young

• unchangeable factors
• age >40
• Premenopause protected by higher HDL levels
• Genetics/lifestyle
• changeable factors
• obesity/high fat diet
• cig smoking
• sedentary lifestyle
• DM (diabetes mellitus)
• HTN
• Oral contraceptives

• decrease cholestrol levels esp LDL
• decrease sodium
• control HTN, diabetes
• stop smoking
• anti-coagulant therapy: coumadin or ASA
• Surgery for atheroma
• -flatten thru cath using balloon
• -LASER
• -CABG reroute blood flow around using veins

O2 deficit due to obstruction or spasm in artery or patient working/exercising harder than usual

insufficient blood supply due to athero, arterio, or artery spasm

• rest
• nitroglycerin
• O2
• with known angina hx 2nd dose of nitroglycerin if still in pain after 5 min; if after 10 min assume heart attack

• coronary artery totally obstructed
• ischemia/cell death
• usually from atherosclerosis
• quick attention decreases area of necrosis

• pain in chest, left arm, and neck
• pain described as steady, severe, crushing with no relief
• sometimes misinterpreted as gastric pain
• pallor/sweating
• hypotension, pulse weak/rapid
• low grade fever

• Rest
• O2 therapy
• analgesics
• anticoagulants
• cardiac rehab programs
• -individualized exercise plan, schedule for return to normal function

30-40% mortality in 1st year

• cessation of all heart activity
• ECG flat line
• all cardiac function ceased
• no impulse conduction
• heart and brain deprived of O2

• heart unable to pump enough blood
• may be problem in heart ie valve or from HTN or a lung disease
• body may attempt to compensate resulting in less blood to organs

• CO/SV decrease
• "backup" congestion in circulation occurs
• blood inflow>output

• infarcts that effect pumping capacity of heart
• valve defects
• congenital heart defects
• CAD leading cause

• fatigue, weakness, dyspnea
• SOB, exercise intolerance
• cold intolerance

• HTN or infarction of left ventricle
• orthopnea/dyspnea
• left ventricle circulation backup into pulmonary artery (drowning lungs)
• cough
• paroxysmal nocturnal dyspnea

• cannot keep up with output
• blood backs up into LEs
• dependent edema
• hepatomegaly/spleenomegaly
• ascitis (fluid accumulates in abdominal cavity)
• Pressure on vena cava
• -distended neck veins, HA, facial flushing and visual distrubances

• acute inflam 5-15 y/o
• new streptococcus strains occur
• occurs after a few weeks of an untreated infection
• antibodies form usually but then react abnormally
• may affect larg ejoint in the child especially legs, may migrate
• also may effect skin, other joints with subcutaneous nodules
• may affect brain resulting in jerky movement of face, arms/legs

• systemic inflam: low grade fever and malaise
• anorexia
• fatigue
• tachycardia, heart murmurs, acute HF, arrthymias

• penicillin
• anti-inflam (ASA/cortico steroids)