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60 year-old woman with history of obesity and Type 2 diabetes has…
60 year-old woman with history of obesity and Type 2 diabetes has experienced a heart attack
ANATOMY of the HEART
Superior/Inferior Vena Cava
Pulmonary Arteries
SA Node
Fossa Ovalis
Right Atrium
Tricuspid
Chordae Tendonae
Papillary muscles
Right Ventricle
Pulmonary Semilunar Valve
Pulmonary Trunk
Left Atrium
Bicuspid/Mitral Valve
Left Ventricle
Interventricular Septum
Endocardium
Myocardium
Epicardium
Aorta Semilunar Valve
Aorta Arch
Pulmonary Veins ( 4)
PATHWAY of BLOOD THROUGH the HEART
Blood Enters into the Heart:
Superior/Inferior Vena Cava
Right atrium
Tricuspid
Right Ventricle
Pulmonary Semilunar Valve
Pulmonary Trunk
Right/Left Pulmonary Artery
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SOUNDS of the HEART
The "Lub" sound is Atrium ( tricuspid/bicuspid ) valves closing
The "Dub" sound is the Aortic/Pulmonary valves closing
P (Atrial depolarization/contraction)
QRS (Ventricle Depolarization)
the "lub" occurs
T ( ventricle repolarization )
the "dub" occurs
atrial repolarization
Roles of Valves and Papillary Muscle
Valves:
Prevent backflow into atrium when the ventricles contract
Tricuspid Valve
3 flexible cusps ( flaps of endocardium reinforced by connective tissue cores)
Bicuspid/Mitral Valve
2 cusps
Semilunar Valves:
guard bases of large arteries
prevent backflow into the associated ventricles
3 pocket-like cusps
open/close in response to differences in pressure
Papillary Muscles
:
act as tethers that anchor the valve flaps in their closed position
contract with the other ventricular musculature so that they take up the slack on the chordae tendineae as the full force of the ventricular contraction hurls the blood against the Valve flaps
Different Concepts of the Heart
Stroke Volume:
the volume of blood pumped out by one ventricle with each beat
correlates with the force of ventricular contraction
Cardiac Output:
is the amount of blood pumped out by each ventricle in 1 min
it is the product of heart rate and stroke volume
Preload:
is the degree to which cardiac muscle cells are stretched out before they contract
controls stroke volume
the higher the preload, the higher the stroke volume
how much blood is in the heart before contraction
Afterload:
is the pressure that the ventricles must overcome to eject blood
essentially the back pressure that arterial blood exerts on the aortic and pulmonary valves
Peripheral Resistance:
resistance of the arteries to the blood flow
arteries constrict, resistance increase
Determine by 3 factors
Autonomic Activity
sympathetic activity constricts peripheral arteries
Pharmacologic agents
vasoconstrictor drugs increase resistance while vasodilator drugs decrease it.
Blood viscosity
increased viscosity increases resistance.
Relationship Between Heart Function and Blood Pressure & Respiratory Rate
Indirect and Direct Factors
Obesity
High intake of Sodium, Cholesterol, Saturated fat
not exercising
Smoking
Nicotine causes intense vasoconstriction
Possible Heredity
Age
Hypertension usually appears after the age 40
Stress
Failed Mitral Valve
blood backflow to left atrium
blood not being pump into left ventricle
the blood is just swishing back and forth instead of being pump to the aorta properly
not enough blood being pump to the rest of the body
organs and tissues not receive enough oxygenated blood
for example, your kidneys
kidneys not receiving enough blood, they become damaged
they wont be able to do their job; clean the blood, removing waste products and extra water, make red blood cells, and help control pressure
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can lead to pulmonary hypertension
causing your heart to work harder and harder
increasing the pressure of your pulmonary arteries
irregular heart beats
can lead to blood clots
essentially having a heart attack
fluid will build up in lungs ( pulmonary edema )
causing shortness of breathe
in some cases, cough of blood
strains the right side of the heart
leading to cause heart failure
pressure build up
results in left atrium to become enlarged