1. Medical Therapeutics: November 3, 2017
Heart Grahams
Medical Therapeutics: November 3, 2017

2. Bell Work
Take a sheet of paper out to turn in. DO NOT USE NOTES! THIS WILL BE GRADED ON EFFORT AND TO CONFIRM UNDERSTANDING! WRITE THE BLOOD FLOW OF THE HEART

3. PHYSIOLOGY OF THE HEART The heart is a double pump
PHYSIOLOGY OF THE HEART The heart is a double pump. When the heart beats…
Right Heart Deoxygenated blood flows into heart from vena cava  right atrium  tricuspid valve  right ventricle  pulmonary semilunar valve  pulmonary artery  lungs (for oxygen)
Left Heart Oxygenated blood flows from lungs via pulmonary veins  left atrium  mitral valve  left ventricle  aortic semilunar valve  aorta  general circulation (to deliver oxygen)

4. VITAL SIGNS TEST
REVIEW TEST

5. Pericarditis Pericardial Effusion Cardiac Tamponade
What’s the difference??
Pericarditis
Pericardial Effusion
Cardiac Tamponade

6. Pericarditis: Signs and Symptoms
Suffix - itis means Inflammation
Pericarditis: is the inflammation of the pericardium
Pericardium: two thin layers of a sac-like tissue that surrounds the heart, holds it in place and helps it work. 
Symptoms: CHEST PAIN - caused by the sac’s layers becoming inflamed and possibly rubbing against the heart

7. Pericarditis: Causes and Treatments
Causes: viral, bacterial, fungal, and other infections. Other possible causes are heart attack or heart surgery, medical conditions, injuries and medicines. Pericarditis often occurs after a respiratory infection. Chronic, or recurring pericarditis is usually the result of autoimmune disorders in which the body's immune system makes antibodies that mistakenly attack the body's tissues or cells. Treatment: pericarditis is mild and clears up on its own with rest or simple treatment such anti-inflammatory drugs or pain relievers

8. Pericardial Effusion
accumulation of too much fluid in the double-layered, sac-like structure around the heart (pericardium).
The space between the layers normally contains a thin layer of fluid. But if the pericardium is diseased or injured, the resulting inflammation can lead to excess fluid.
Fluid can also build up around the heart without inflammation, such as from bleeding after a chest trauma.
Puts pressure on the heart, affecting the heart's function.
If untreated, it can lead to heart failure or death.

10. Pericardial Effusion Signs & Symptoms
You can have significant pericardial effusion without signs or symptoms, particularly if the fluid has increased slowly.
Shortness of breath or difficulty breathing (dyspnea)
Discomfort when breathing while lying down (orthopnea)
Chest pain, usually behind the breastbone or on the left side of the chest
Chest fullness

11. Pericardial Effusion Treatment
Depend on how much fluid has accumulated, what's causing the effusion and whether you have or are likely to develop cardiac tamponade. Treating the cause of pericardial effusion often corrects the problem.
Medicines that can treat: Aspirin/NSAIDs, Colchicine, Steroids, Antibiotics
The pericardium can stretch somewhat to accommodate the excess fluid.
Too much fluid causes the pericardium to put pressure on the heart, which keeps the chambers from filling completely.

12. Cardiac Tamponade
If pericardial effusion persists, it developes into Cardiac Tamponade
Serious medical condition in which blood or fluids fill the space between the sac that encases the heart and the heart muscle.
This places extreme pressure on your heart. The pressure prevents the heart's ventricles from expanding fully and keeps your heart from functioning properly. Your heart can’t pump enough blood to the rest of your body when this happens. This can lead to organ failure, shock, and even death.
Cardiac tamponade is a medical emergency.

13. Cardiac TamponadeTreatment
Drain the fluid. Your doctor can enter the pericardial space with a needle and then use a small tube (catheter) to drain fluid — a procedure called pericardiocentesis.
The doctor will use imaging devices — either echocardiography or a type of X-ray technology called fluoroscopy — to guide the work.
An ECG machine monitors your heart during the procedure. In most cases, the catheter will be left in place to drain the pericardial space for a few days to help prevent the fluid from building up again.

14. Cardiac Tamponade Treament
Open heart surgery. If there's bleeding into the pericardium, especially due to recent heart surgery or other complicating factors, you might have surgery to drain the pericardium and repair damage. Occasionally, a surgeon may drain the pericardium and create a "passage" that allows it to drain as necessary into the abdominal cavity where the fluid can be absorbed.

16. Pericardiocentesis

17. Heart Grahams