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The Cardiovascular System (The Heart): A 60 year old woman with a history…
The Cardiovascular System (The Heart): A 60 year old woman with a history of obesity and DM II has experienced a heart attack that caused permanent damage to the papillary muscle of the left ventricle, resulting in a failure of the mitral valve to close. Her BP is 95/55, her breathing rate is 30 BPM, and her HR is 125. Her breathing is labored and you hear gurgling when you listen through a stethoscope. her son asks "what is a myocardial infarction, what do her symptoms mean, and what does mitral valve failure imply?
Background
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Heart Valves
2 Atrioventricular valves- prevent back flow into the atria when the ventricles contract (papillary muscle- plays a role in valve function)
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Heart sounds
basic rhythm is lub-dub, pause, lub-dub
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the first sound occurs as the AV valves close. signifies the point when ventricular pressure rises above atrial pressure
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Regulation of HR
when blood volume drops or the heart is seriously weakened stroke volume declines and cardiac output is maintained by increasing the heart rate
the autonomic nervous system also affects heart rate. when emotional or physical stressors activate the sympathetic system the heart responds by beating faster
Age, gender, exercise and body temp also influence HR
Myocardial infarction
Commonly called a heart attack in which cells die. since cardiac muscle is amitotic most of the dead tissue is replaced with non contractile scar tissue
Downstream effects
failed mitral valve
left sided heart failure (swelling of the legs, shortness of breath, fatigue, higher risk of developing a heart arrhythmia
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affect on other systems
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activates sympathetic nervoues system (causes and increase in the HR) causes a need for oxygen. decreases cardiac output which lowers BP
Low cardiac output leads to decrease cerebral pressure which leads to the body releasing anti-diaretic hormones which makes the kidneys increase water reapsorption leading to more fluid buildup
chronic heart failure leads to fatigue . the fatigue is caused by decreased cardiac output, impaired perfusion to vital organs, decreased oxygenation of the tissues, and anemia
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