1. Chapter 13
Heart

2. Functions of the Circulatory System
The heart is the pump that circulates blood to all parts of the body
Arteries, veins, and capillaries transport the blood
Blood carries oxygen and nutrients to the cells and carries waste products away
Lymph system returns excess fluid from the tissues the circulation

3. 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

4. The Heart About 5 inches long and 3.5 inches wide 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

5. Figure 13-1 The heart is located in the thoracic cavity between the lungs

6. 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)

7. Structure of the Heart (1 of 2)
Hollow, muscular, double pump
Pericardium and pericardial fluid
Epicardium
Myocardium
Cardiac muscle tissue
Endocardium

8. Structure of the Heart (2 of 2)
Superior and inferior vena cava
Coronary sinus
Pulmonary artery
Pulmonary veins
Aorta

9. Figure 13-2 Anterior external view of the heart

10. Figure 13-3 Anterior cross-sectional view of the heart

11. Chambers and Valves (1 of 2)
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

12. Chambers and Valves (2 of 2)
Lower chambers
Left and right ventricles
Valves keep blood flowing in one direction

13. Valves Atrioventricular valves Semilunar valves
Tricuspid valve (separates the right atria and right ventricle)
Bicuspid or mitral valve (separates the left atria and left ventricle)
Semilunar valves
Pulmonary semilunar valve (opening of the pulmonary arteries)
Aortic semilunar valve (opening of the aorta)

14. Physiology of the Heart
Double pump
Right heart
Deoxygenated blood
Left heart
Oxygenated blood

15. Heart Rate and Cardiac Output
Normal adult rate is between 72 and 80 beats per minute
Cardiac output=stroke volume x heart rate
Calculating the cardiac output
Exercise increases cardiac output

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

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

18. Figure 13-7 An electrical impulse from the SA node travels to the AV node and causes the ventricle to contract

19. ECG or EKG (1 of 2)
The electrocardiogram is a device to record the electrical activity of the heart
Systole
Contraction
Diastole
Relaxation

20. ECG or EKG (2 of 2) Positive and negative deflection
P, QRS, and T waves

21. Cardiovascular Technologists and Technicians
Also known as ECG Technicians
Assist Physicians in diagnosing and treating cardiac and peripheral vascular disease.
Take electrocardiograms and the more skilled may do the Holter monitor and stress testing.

22. ECG Technicians Continued
Education to prepare a technician for ECG, Holter, and stress testing is usually a one year certificate program.
Job prospects are not very high for this profession since nurses and others may be trained to do procedures such as ECGs and stress testing.

23. Cardiology Technologists
Specialize in cardiac catheterization procedures
Training for cardiology technologists involves a two year program.
Job prospect is very high for this profession. (Approx. 25% Increase between 2014 and 2024)
Salary Range: $28, ,170
California Annual Mean Wage $71, 230

24. 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

25. Prevention of Heart Disease
Heart disease is the leading cause of death for both men and women in the US
Coronary heart disease
Risk factors
Steps to lower risk or prevent heart disease
Blood cholesterol levels and triglycerides

26. Diagnostic Tests – Noninvasive (1 of 2)
Angiography
Cardiac MRI
Coronary calcium scoring/heart scan
Echocardiography
Electrocardiogram

27. Diagnostic Tests – Noninvasive (2 of 2)
Exercise stress tests
Holter monitor
MUGA (multiple gated acquisition scan)
Nuclear perfusion

28. Diagnostic Tests – Invasive
Cardiac catheterization
IVUS (intravascular coronary ultrasound)
TEE

29. Diagnostic Tests – Blood Tests
Arterial blood gases
BNP
Lipid panel
C-reactive protein
Cardiac Troponin T

30. Diseases of the Heart – Common Symptoms
Arrhythmia
Bradycardia
Tachycardia
Murmurs
Mitral valve prolapse

31. Diseases of the Coronary Artery
Coronary artery disease (CAD)
Angina pectoris
Myocardial infarction

32. Infectious Diseases of the Heart
Pericarditis
Myocarditis
Endocarditis
Rheumatic heart disease

33. Heart Failure (1 of 2)
When the ventricles of the heart are unable to contract effectively and blood pools in the heart
Symptoms depend on which ventricle fails

34. Heart Failure (2 of 2) Left ventricle failure Right ventricle failure
Dyspnea (shortness of breath)
Right ventricle failure
Engorgement of organs, edema of the legs and feet, and ascites

35. Congestive Heart Failure
Similar to heart failure
Left-sided failure – pulmonary edema
Right-sided failure – fluid buildup
throughout body
Treatment

36. EMT’s and Paramedics
Respond to medical emergencies; they determine the nature and extent of the patient’s condition, determine if the patient has preexisting medical problems, provide emergency care and transport to a medical facility.
May be registered at one of four levels by the National Registry of Emergency Medical Technicians: First Responder, EMT Basic, EMT- Intermediate, EMT- Paramedic.

37. EMT’s and Paramedics Continued
Formal Training and Certification are needed in ALL states.
Job outlook is good (Approx. 24% increase from 2014 to 2024)
Salary Range: $20, ,110
California Annual Mean Wage $ 37,410

38. 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

39. Types of Heart Surgery Angioplasty Cardiac stents Coronary bypass
Transmyocardial laser revascularization

40. Heart Transplants Used as a last resort Histocompatibility
Organ rejection

41. Medical Highlights Pacemaker Cardiac resynchronization therapy
Defibrillator
Heart pumps

42. How to Check a Patient’s Pulse
There are four areas you can use to check for a patient’s pulse: carotid, brachial, radial and pedal
The most common site is either the radial or carotid artery
When taking a patient’s pulse you will take two fingers, most often your index and middle finger, and lightly place them over one of these areas

44. Pulse Continued
For a more accurate number the ideal time to take a pulse is 30 seconds
You will then take that number and multiply it by two to get the patient’s heart rate per minute
Normal heart rate= beats per minute

45. Time to Practice!

46. How to Take Blood Pressure

47. LET’S PRACTICE!