1. Chapter 13
Heart

5. Draw the Pathway of Blood Flow

6. AGAIN… Draw, Color & Label 

7. Media Time 

8. Functions of the Circulatory System
The heart is the pump that circulates blood
Arteries, veins, and capillaries transport the blood
Blood carries oxygen and nutrients to the cells and carries waste products away
Lymph system functions

9. Major Blood Circuits
Blood leaves the heart through arteries and returns by veins
Blood circulation routes
General or system circulation
Cardiopulmonary circulation
Changes in the composition of circulating blood

10. The Heart About the size of a closed fist Weighs about 1 pound
Located in the thoracic cavity; the apex of the heart lies on the diaphragm and points to the left of the body

11. The Heart
© 2014 Cengage Learning.

12. The Heart
After 4 to 5 minutes without blood flow, brain cells are irreversibly damaged
Can hear the heartbeat through a stethoscope
Cardiac arrest
Cardiopulmonary resuscitation (CPR)

13. Structure of the Heart Hollow, muscular, double pump
Pericardium and pericardial fluid
Myocardium
Cardiac muscle tissue
Endocardium
Superior and inferior vena cava
Coronary sinus
Pulmonary artery
Pulmonary veins
Aorta

14. Structure of the Heart
© 2014 Cengage Learning.

15. N

16. 14 13 6 1 7 5 2 9 8 12 10 3 4 11

17. Chambers and Valves
Separated into right and left halves by the septum; then each half separated into an upper and lower chamber
Upper chambers
Left and right atria
Lower chambers
Left and right ventricles
Valves keep blood flowing in one direction

18. Valves Atrioventricular valves Semilunar valves Tricuspid valve
Bicuspid or mitral valve
Semilunar valves
Pulmonary semilunar valve
Aortic semilunar valve

21. Physiology of the Heart
Double pump
Right heart
Deoxygenated blood
POOR BLOOD
Left heart
Oxygenated blood
RICH BLOOD

22. Heart Rate and Cardiac Output
Normal adult rate is between 72 and 80 beats per minute (60 to 100 beats a minute)
Stroke volume
is the amount of blood ejected by the left ventricle in one contraction. Although stroke volume can refer to either left or right side of the heart, it is most associated with the left side.
Calculating the cardiac output
Cardiac output is the volume of blood pumped by the heart per minute (mL blood/min). Cardiac output is a function of heart rate and stroke volume. The heart rate is simply the number of heart beats per minute. The stroke volume is the volume of blood, in milliliters (mL), pumped out of the heart with each beat.
Exercise increases cardiac output

23. Heart Sounds Valves make sounds when they close
Called lubb dupp sounds
Lubb
Tricuspid and bicuspid valves (S1)
Dupp
Aortic and pulmonary valves (S2)

24. Conduction System
Electrical impulses cause rhythmic beating of the heart
Sinoatrial (SA) node or pacemaker
Atrioventricular (AV) node
Bundle of His
Purkinje fibers

25. The heartbeat happens as follows:
The SA node (called the pacemaker of the heart) sends out an electrical impulse.
The upper heart chambers (atria) contract.
The AV node sends an impulse into the ventricles.
The lower heart chambers (ventricles) contract or pump.

26. Conduction System
© 2014 Cengage Learning.

27. ECG or EKG
The electrocardiogram is a device to record the electrical activity of the heart
Systole
Contraction
Diastole
Relaxation

28. ECG or EKG Positive and negative deflection (change direction)
P, QRS, and T waves
Being able to interpretate these details allows diagnosis of a wide range of heart problems.

29. Prevention of Heart Disease
Heart disease is the leading cause of death
Coronary heart disease
Risk factors
High blood cholesterol and triglyceride levels (a type of fat found in the blood)
High blood pressure
Diabetes and prediabetes
Overweight and obesity
Smoking
Lack of physical activity
Unhealthy diet
Stress
The risk factors you can't control are age, gender, and family history

30. Steps to lower risk or prevent heart disease
Eat healthy
Exercise
Blood cholesterol levels and triglycerides

31. Diagnostic Tests – Noninvasive
Angiography
visualize the inside of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers

32. Coronary calcium scoring/heart scan
Cardiac MRI
Cardiac MRI is a common test. It's used to diagnose and assess many diseases and conditions, including: Coronary heart disease. Damage caused by a heart attack. Heart failure.
Coronary calcium scoring/heart scan
Cardiac calcium scoring uses a special X-ray called a computed tomography (CT) scan to find the buildup of calcium on the walls of the arteries

33. Dx: fibrillation Echocardiography Electrocardiogram
Echocardiography uses standard two-dimensional, three-dimensional, and Doppler ultrasound to create images of the heart.
Electrocardiogram
Echocardiogram, often referred to as a cardiac echo or simply an echo, is a sonogram of the heart. (ECG is an abbreviation for an electrocardiogram.)
Dx: fibrillation

34. Electrocardiogram to DX
Fibrillation - a muscular twitching, very rapid irregular contractions of the muscle fibers of the heart atrial fibrillation, ventricular fibrillation
Electrocardiogram to DX

35. Diagnostic Tests – Noninvasive
Exercise stress tests
A stress test, sometimes called a treadmill test or exercise test, helps a doctor find out how well your heart handles work. As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart.

36. MUGA (multiple gated acquisition scan)
Holter monitor
A Holter monitor is a continuous tape recording of a patient's EKG for 24 hours. Since it can be worn during the patient's regular daily activities, it helps the physician correlate symptoms of dizziness, palpitations (a sensation of fast or irregular heart rhythm) or black outs.
MUGA (multiple gated acquisition scan)
highly accurate test used to determine the heart's pumping function, nuclear imaging test.

37. Diagnostic Tests – Invasive
Cardiac catheterization
Cardiac catheterization (cardiac cath or heart cath) is a procedure to examine how well your heart is working. A thin, hollow tube called a catheter is inserted into a large blood vessel that leads to your heart.

38. IVUS (intravascular coronary ultrasound)
test that uses sound waves to see inside blood vessels. It is useful for evaluating the coronary arteries that supply the heart.

39. Diagnostic Tests – Blood Tests
Arterial blood gases
measures the amounts of certain gases (such as oxygen and carbon dioxide) dissolved in arterial blood. An ABG test involves puncturing an artery with a thin needle and syringe and drawing a small volume of blood.
BNP
a substance secreted from the ventricles or lower chambers of the heart in response to changes in pressure that occur when heart failure develops and worsens. The level of BNP in the blood increases when heart failure symptoms worsen, and decreases when the heart failure condition is stable.

40. Lipid panel C-reactive protein
Lipids include cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. The basic lipid panel measures total cholesterol, triglyceride levels, HDL and LDL cholesterol.
C-reactive protein
produced by the liver. The level of CRP rises when there is inflammation throughout the body. It is one of a group of proteins called "acute phase reactants" that go up in response to inflammation

41. Cardiac Troponin T
indicators of damage to the heart muscle (myocardium). They are measured in the blood to differentiate between unstable angina and myocardial infarction (heart attack) in people with chest pain.

42. Effects of Aging Heart muscle fibers replaced by fibrous tissue
Heart valves increase in thickness
Cardiac output decreases
Changes become more significant when elderly person becomes physically or mentally stressed

43. Diseases of the Heart – Common Symptoms
Arrhythmia-change from normal rate/rhythm
Bradycardia-slow/heart beats less then 60 beats/min
Tachycardia- fast/heart beast more then 100 beats/min
Murmurs- valve fails to close properly (hissing sound or gurgling sound) surg to replace if necessary
Mitral valve prolapse- between LA & LV closes imperfectly (s/s: fatigue, palpitations, HA, Chest Pain, Anxiety)

44. Diseases of the Coronary Artery
Coronary artery disease (CAD)- narrowing of the arteries, plaque builds up and causes Heart Attack
Angina pectoris- Chest Pain (Call 911, lie down, ASA, Nitro to open artery)
Myocardial infarction- MI/Heart Attack (s/s: chest pain, nausea, sweating, fatigue, dyspnea/difficulty breathing) DAMAGE HEART MUSCLE CANT PUMP BLOOD.

45. Infectious Diseases of the Heart
Pericarditis- Inflammation outer member covering of heart
Myocarditis- Inflammation of heart muscle
Endocarditis- Inflammation membrane that lines heart valves & heart CAN lead to Fatal BLOOD CLOT)
Rheumatic heart disease- result from frequent strep throat, attack lining of heart

46. Heart Failure
When the ventricles of the heart are unable to contract effectively and blood pools in the heart
Symptoms depend on which ventricle fails
LEFT Ventricle=S/S: Dyspnea occurs
RIGHT Ventricle=Organ fill with blood, S/S: edema, lung congestion, coughing

47. Heart Failure Left ventricle failure Right ventricle failure Dyspnea
Engorgement of organs, edema, and ascites(serous fluid in abd cavity)

48. Congestive Heart Failure
Similar to heart failure
Left-sided failure
pulmonary edema
Right-sided failure
fluid buildup throughout body
Treatment
medication & diuretics

49. Rhythm/Conduction Defects
Heart block
First-degree block
Second-degree block
Third-degree block or complete heart block
Premature contractions
Atrial fibrillation
PVCs
Ventricular fibrillation

50. Types of Heart Surgery Angioplasty Cardiac stents
surgical repair or unblocking of a blood vessel, especially a coronary artery.
Cardiac stents
a tube-shaped device placed in the coronary arteries that supply blood to the heart, to keep the arteries open in the treatment of coronary heart disease

51. Transmyocardial laser revascularization
Coronary bypass
During coronary artery bypass graft surgery (also called CABG), a blood vessel is removed or redirected from one area of the body and placed around the area or areas of narrowing to "bypass" the blockages and restore blood flow to the heart muscle. This vessel is called a graft.
Transmyocardial laser revascularization
a new treatment aimed at improving blood flow to areas of the heart that were not treated by angioplasty or surgery. A special carbon dioxide (CO2) laser is used to create small channels in the heart muscle, improving blood flow to the heart muscle.

52. Heart Transplants Used as a last resort Histocompatibility
matching of tissue type
Organ rejection

53. Medical Highlights Read in Class
Pacemaker
A pacemaker is a small device that's placed in the chest or abdomen to help control abnormal heart rhythms. This device uses low-energy electrical pulses to prompt the heart to beat at a normal rate. Pacemakers are used to treat arrhythmias. Arrhythmias are problems with the rate or rhythm of the heartbeat.

54. Cardiac resynchronization therapy
improves the heart's efficiency and increases blood flow, patients have reported alleviations of some heart failure symptoms

55. Defibrillator
a common treatment for life-threatening cardiac dysrhythmias and ventricular fibrillation. Defibrillation consists of delivering a therapeutic dose of electrical current to the heart with a device called a defibrillator.

56. Heart pumps
The left ventricular assist device, or LVAD, is a mechanical pump that is implanted inside a person's chest to help a weakened heart pump blood throughout the body.