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A 60-year-old woman has experienced a myocardial infarction (heart attack)

- - - - History of Obesity
      - Diabetes Mellitus II
    - - Experienced Myocardial Infarction (Heart Attack)
        
        Permanent damage to the papillary muscles of the mitral valve to close
      - Blood pressure is 95 over 55
      - Breathing rate is about 30 breaths per minute
      - Heart rate is about 125 beats per minute
- - - - 1) Once blood travels through the pulmonic valve, it enters your lungs. ("Pulmonary Circulation")
      - 2) From your pulmonic valve, blood travels to the pulmonary artery to tiny capillary vessels in the lungs
      - 3) Here, oxygen travels from the tiny air sacs in the lungs, through the walls of the capillaries, into the blood
      - 4) At the same time, carbon dioxide, a waste product of metabolism, passes from the blood into the air sacs
      - 5) Carbon dioxide leaves the body when you exhale
      - 6) Once the blood is purified and oxygenated, it travels back to the left atrium through the pulmonary veins.
    - - Trabeculae Carneae
        
        Rounded or irregular muscular columns which project from the inner surface of the right and left ventricle of the heart
      - Intraventicular Septum
        
        the wall of the heart intermediate to the right and left ventricles
        
        Its surface markings correspond to the anterior and posterior interventricular grooves
        
        the septum is as muscular as the left ventricle
      - Heart Wall 3 layers
        
        Myocardium
        
        thick middle layer
        
        It is an involuntary, striated muscle that constitutes the main tissue of the walls of the heart
        
        Epicardium
        
        The outer layer of the pericardium, a conical sac of fibrous tissue that surrounds the heart and the roots of the great blood vessels
        
        the outer layer of the heart wall
        
        Endocardium
        
        the innermost layer of tissue that lines the chambers of the heart
        
        Its cells are embryologically and biologically similar to the endothelial cells that line blood vessels
      - Chordea Tendinea
        
        A group of tough, tendinous strands in the heart
        
        Plays a vital role in holding the atrioventricular valves in place while the heart is pumping blood
      - Superior Vena Cava
        
        It is a large-diameter (24 mm) short length vein that receives venous return from the upper half of the body, above the diaphragm.
      - Pulmonary Artery
        
        Arises from the right ventricular outflow tract and courses posteriorly and superiorly to the left of and posterior to the aorta
      - Pulmonary Vein
        
        Two main pulmonary veins emerge from each lung hilum, receiving blood from three or four bronchial veins apiece and draining into the left atrium.
        
        An inferior and superior main vein drains each lung
        
        the left in front of the descending thoracic aorta.
        
        The right main pulmonary veins (contains oxygenated blood) pass behind the right atrium and superior vena cava
        
        Behind the pulmonary artery is the bronchus.
        
        the inferior is situated at the lowest part of the lung hilum.
      - Left Atrium
        
        The left atrium consists of three parts: the vestibule, the left atrial appendage, and the pulmonary-vein component.
        
        The left atrium is more or less oval-shaped
        
        Its extension is greater in the superior-inferior aspect than in the antero-posterior or medial-lateral aspect
      - Right Atrium
        
        the right atrium forms the right border of the heart
      - Mitral Valve
        
        The mitral valve connects the left atrium (LA) and the left ventricle (LV)
      - Left Atrium
        
        The left atrium consists of three parts: the vestibule, the left atrial appendage, and the pulmonary-vein component
        
        The left atrium is more or less oval-shaped.
        
        Its extension is greater in the superior-inferior aspect than in the antero-posterior or medial-lateral aspect.
      - Aortic Valve
        
        a valve in the human heart between the left ventricle and the aorta
        
        It is one of the two semilunar valves of the heart, the other being the pulmonary valve.
      - Tricuspid Valve
        
        consists of the annulus, leaflets, right ventricle, papillary muscles and chordae tendinae
        
        lies between the right atrium and the right ventricle and is placed in a more apical position than the mitral valve
      - Left Ventricle
        
        the thickest of the heart's chambers
        
        located in a posterior and lateral location relative to the right ventricle. With right ventricle, it forms apex of heart.
      - Pulmonary Valve
        
        the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps.
      - Right Ventricle
        
        the most anterior of the four heart chambers.
        
        extends from the right atrium to the apex of the heart
      - Inferior Vena Cava
        
        formed by the joining of the left and right common iliac veins and brings collected blood into the right atrium of the heart.
        
        Also joins with the azygos vein (which runs on the right side of the vertebral column) and venous plexuses next to the spinal cord.
  - - - Valves in the heart
        
        Bicuspid Valve
        
        Closes off the lower right chamber
        
        Opens to allow blood to be pumped from the heart to the lungs (through the pulmonary artery) where it will receive oxygen.
        
        Mitral Valve
        
        Closes off the upper left chamber (or left atrium) collecting the oxygen-rich blood coming in from the lungs.
        
        Opens to allow blood to pass from the upper left side to the lower left side (or from the left atrium to the left ventricle).
        
        Tricuspid Valve
        
        Closes off the upper right chamber (or atrium) that holds blood coming in from the body
        
        Opens to allow blood to flow from the top right chamber to the lower right chamber
        
        Prevents the back flow of blood from the ventricle to the atrium when blood is pumped out of the ventricle
        
        Aortic Valve
        
        Closes off the lower left chamber that holds the oxygen-rich blood before it is pumped out to the body.
        
        Opens to allow blood to leave the heart (from the left ventricle to the aorta and on to the body).
      - Papillary Muscles
        
        Prevents prolapse of anterior and posterior cusps of mitral valve during systole
    - - A normal heartbeat has two sounds, a lub (sometimes called S1) and a dub (S2). These sounds are caused by the closing of valves inside your heart.
    - - your heart pushes your blood through a network of blood vessels called arteries
        
        As the blood travels through the arteries it pushes against the sides of these blood vessels and the strength of this pushing is called your blood pressure
        
        As your heart squeezes and pushes your blood through your arteries, your blood pressure goes up
        
        As your heart squeezes and pushes your blood through your arteries, your blood pressure goes up
        
        So, with each heartbeat, your blood pressure will rise to a maximum level and then fall to a minimum level.
    - - The Pulmonary Loop
        
        The right side of the heart picks up the oxygen-poor blood from the body and moves it to the lungs for cleaning and re-oxygenating
      - The Systemic Loop
        
        Once the blood is re-oxygenated, the left side of the heart moves the blood throughout the body, so that every part receives the oxygen it needs
    - - Mean Arterial Pressure
        
        Define: As the average pressure in a patient's arteries during one cardiac cycle
      - Preload
        
        Define: The initial stretching of the cardiac myocytes prior to contraction
      - Cardiac Output
        
        Define: The amount of blood the heart pumps through the circulatory system in a minute
      - Afterload
        
        Define: The force against which a ventricle contracts that is contributed to by the vascular resistance especially of the arteries and by the physical characteristics of the blood
      - Stroke Volume
        
        Define: The amount of blood pumped by the left ventricle of the heart in one contraction
      - Peripheral Resistance
        
        Define: The resistance of the arteries to blood flow
      - Heart Rate
        
        Define: The number of heartbeats per unit of time
- - - - This is a condition in which there's increased pressure in the arteries that carry blood from your heart to your lungs (pulmonary arteries), causing your heart to work harder.
    - - Allowing blood to flow backward into the left atrium
        
        As a result, your heart does not pump enough blood out of the left ventricular chamber to supply your body with oxygen-filled blood.
  - - - Cardiac Arrest
        
        Death results when the heart suddenly stops working properly
      - Arrhythmias
        
        Irregular Heart Rhythm
      - Stroke
        
        The sudden death of brain cells due to lack of oxygen, caused by blockage of blood flow or rupture of an artery to the brain
    - - causing irregularities in the way fluid is carried away from the lung
      - Pulmonary Edema
        
        When the heart is not able to pump efficiently, blood can back up into the veins that take blood through the lungs
        
        As the pressure in these blood vessels increases, fluid is pushed into the air spaces (alveoli) in the lungs
    - - Renal Failure, when the kidneys don't work as well as they should, not getting enough blood to filter
        
        Heart may become too full of blood. This causes pressure to build in the main vein connected to your kidneys, which may lead to a blockage and a reduced supply of oxygen rich blood to the kidneys
    - - The sympathetic nervous system (SNS) is activated and the imbalance of the activity of the SNS and vagal activity interaction occurs
        
        The abnormal activation of the SNS leads to further worsening of heart failure
        
        Define: that contains chiefly adrenergic fibers and tends to depress secretion, decrease the tone and contractility of smooth muscle, and increase heart rate
    - - A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle and damaging it
      - Coronary Artery Disease the narrowing or blockage of the coronary arteries caused by atherosclerosis ("hardening" or "clogging" of the arteries)
        
        Without adequate blood, the heart becomes starved of oxygen and the vital nutrients it needs to work properly
        
        Later on, can lead to a myocardial infarction
    - - The damage caused by a heart attack triggers an inflammatory reaction which degrades the affected tissue
        
        Activation of the response occurs in clusters of immune cells (lymphocytes) within the fatty tissues of the so-called pericardium, which surrounds the heart
        
        In the aftermath of an acute heart attack, these clusters are responsible for initiating and coordinating the ensuing immune response
        
        Lymphocytes are activated and signaling molecules called cytokines are secreted, which recruit neutrophils to the damaged area of the heart muscle.
        
        The neutrophils in turn induce an inflammation reaction that results in the degradation of the damaged tissues by phagocytes, and they subsequently help resolve the primary inflammation reaction and promote tissue repair.