A 60-year old female with a history of obesity and DM II experienced a…
A 60-year old female with a history of obesity and DM II experienced a myocardial infarction causing a failure of the mitral valve to close.
Permanent damage to the papillary muscle of the left ventricle directly causes mitral valve to fail to close.
Anatomy of heart + relevant structures
Left and right ventricles
Left and right atriums
Tricuspid and bicuspid atrioventricular valves
Pulmonary and aortic semilunar valves
Superior and inferior vena cava
Direct effects of failed mitral valve
Backflow into left atrium
Heart rhythm issues
left-sided heart failure
Increased heart rate
Heart murmurs/abnormal heart sounds
Consequences on other systems
Respiratory system: lungs fill with blood, causing difficulty breathing
Circulatory system: Blood is unable to oxygenate body
All other systems: Failure to function due to lack of oxygen
Nervous system: failure to conduct action potentials due to lack of calcium, sodium, potassium, acetylcholine, etc
Endocrine system: failure to function due to lack of transportation of hormones
Urinary system: unable to properly function due to lack of transportation of sodium, hormones, water, etc.
Muscular system: tetanus/muscle spasms/etc due to lack of calcium, sodium, and acetylcholine
Pathway of blood through heart
tricuspid AV valve
pulmonary SL valve
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Role of valves + papillary muscles
Tricuspid AV valve prevents backflow into right atrium
Pulmonary SL valve prevents backflow into right ventricle
Mitral valve prevents backflow into left atrium
Aortic SL valve prevents backflow into left ventricle
Papillary muscles - anchor chordae tendinae
Chordae tendinae - prevent tricuspid AV valve from bending back into right atrium
Normal sounds of heart + what causes them
Lub caused by closing of AV valves
Dub caused by closing of SL valves
Relationship between heart function and blood pressure
If the heart is functioning well, blood pressure will remain constant.
Higher blood pressure can indicate issues with the heart working too hard
Lower blood pressure can indicate the heart functioning well
Relationship between heart function and respiratory rate
If the heart is functioning effectively and properly, blood should be pumping well and spreading oxygen well, causing the lungs to not work as hard and keep a normal respiratory rate.
The more effective the heart function is, the lower the respiratory rate.
If the heart has problems and is not pumping blood as well, the lungs will pump harder and faster to increase oxygenation of the body
The more problems/severity of the problems, the higher the respiratory rate
The concepts of heart rate, stroke volume, cardiac output, mean arterial pressure, preload,
afterload, peripheral resistance, backflow, etc
Stroke volume - amount of blood pumped out during ventricular ejection
Ventricular ejection - When ventricle pumps out blood
end systolic volume (ESV) - amount of blood left in ventricle at the end of systole
end-diastolic volume (EDV) - the volume of blood in ventricle at end of diastole
Preload - amount of ventricular stretching
Ventricular filling - when ventricle fills up with blood.
Backflow - when blood goes back into the previous chamber during contraction; caused by valve issues.
Heart rate - how fast the heart pumps blood
Cardiac output - amount of blood pumped by a single ventricle in one minute
Heart rate - number of times the heart contracts per minute
Mean arterial pressure - average blood pressure during one cardiac cycle
Afterload - the pressure the heart must work against to pump blood
Peripheral resistance - resistance of arteries to blood flow
Indirect effects of failed mitral valve
Lungs filling with blood
Unable to breathe
Difficulty oxygenating body
Increased breathing rate
Obesity and Diabetes Mellitus II is related to heart issues and can cause plaque to build up in blood vessels, further increasing risk of heart issues