TheCardiovascular System

& Cardiovascular Emergencies

Supplies oxygenated blood to all cells in the body!!

Components Heart – pumps blood

Vessels – Arteries carry blood away from the heart and veins carry blood back to the heart

Blood – fluid that carries nutrients essential to cell function

The Heart

Located in the thoracic cavity 2nd intercostal space at right sternal

border 5th intercostal space at left

midclavicular line about size of your clenched fist In mediastinum

The Heart

4 chambers “2 sided” - divided by septum 2 upper called atria 2 lower called ventricles surrounded by pericardium system of one way valves

Path of blood flow (Systemic circulation)

left ventricle aorta arteries, arterioles, capillaries, etc ... Vena cava (superior and inferior) Right atrium

Path of blood flow (Pulmonary circulation)

right ventricle pulmonary artery lung ( pulmonary capillaries) Pulmonary veins Left atrium

The Circulatory System

Blood Flow Through the Heart

The Heart

Electrical System independent stimulates contractions of heart normally initiated in right atrium if initiated from other areas =

abnormal

Electrical Conduction

Sinoatrial (SA) node Atrioventricular node Bundle of His

(AV bundle) Bundle branches Purkinje fibers

Vessels

Arteries Arterioles Capillaries Veinioles Veins

Vessels

Vasoconstriction

Effect on Blood Pressure?

Vasodilation

Effect on Blood Pressure?

Major Arteries and Veins

• Aorta

• Pulmonary

• Carotid

• Femoral

• Brachial

• Radial

• Superior vena cava

• Inferior vena cava

• Pulmonary

Look Up in TEXT!

coronary arteries – Supply blood to heart muscle itself

The two main coronary arteries have openings immediately above the aortic valve at the beginning of the aorta where the pressures are highest

Blood

Liquid Portion - Plasma

Solid Portion Red blood cells White blood cells Platelets

Blood

Plasma - transports solids

It is basically a salt solution

Blood

Red Blood cells - carry oxygen

AKA - Erythrocytes

Hemoglobin is the substance that

combines with oxygen in a red blood

cell

Blood

White Blood cells - fight infection

AKA Leukocytes

almost all blood cells (red or white) are made in the bone marrow.

Blood

Platelets – are essential for formation of blood clots. They perform coagulation.

AKA - thrombocytes

average amount of blood in an adult is 4-6 liters.

note

Systemic Vs pulmonary circulation Pulmonary artery Pulmonary vein Coronary arteries Pericardium Myocardium

If the cardiovascular system is working as it should ...

You get…Perfusion

Definition – Adequate flow of blood through body tissue or organs to meet the needs of the cell.

Cardiovascular Emergencies

Abnormal Heart Conditions

Angina Pectoris Myocardial Infarction Congestive Heart Failure

Angina Pectoris

Decreased blood flow to heart muscle results in ischemia- lack of oxygen

Causes mild to moderate pain Pain may radiate Usually lasts 3-8 minutes (rarely longer than 15

mins) IT GOES AWAY with no permanent damage to

heart muscle Can be difficult to differentiate from heart attack

Acute Myocardial Infarction

decreased flow of blood to the myocardium leading to death of tissue

may not be provoked moderate to severe pain Can last between 30 minutes and several hours May not go away with rest, O2 or nitroglycerin Immediate transport is essential

AMI Signs and Symptoms

Sudden onset of weakness, nausea, and diaphoresis

Chest pain or discomfort dyspnea irregular pulse Pain in lower jaw, arms, or back Sudden fainting Pulmonary edema Sudden death Feeling of impending doom

there are always exceptions ...

Referred pain

Atypical pain

No pain

Congestive Heart Failure

Causes diseased heart valves and

damaged ventricles Chronic hypertension obstructive pulmonary disease

(emphysema, chronic bronchitis) often a complication of an MI

CHF

Heart tries to compensate. Increased heart rate Enlarged left ventricle The heart can not efficiently pump the amount of

fluid in the body and CHF develops Fluid backs up into lungs or body as heart fails

to pump

Signs & Symptoms of CHF

Pedal edema JVD Ascites

Critical CHF & Pulmonary Edema

dyspnea rales & audible rales pink frothy sputum tachycardia cyanosis anxiety, restlessness

Vascular emergencies

Atherosclerosis & arteriosclerosis Thrombus Embolus Aneurysm

Athero/arterio -sclerosis

build up of fatty deposits & calcium

causes narrowing of the lumen

can create rough inner surface that can lead to clot

Athero/arterio -sclerosis

Results in: restricted blood flow

high blood pressure

AMI

Thrombus

formation of clot and debris in vessels from plaque

can become large enough to occlude vessel

partial blockage = distal reduction of O2 complete blockage = distal tissue death

Embolus

a thrombus that breaks off from vessel wall.

flows through blood vessels may partially or completely occlude

smaller artery occlusion will result in decreased oxygen

to tissue or tissue death

Aneurysm

is a ballooning out of a weakened section of an artery

Possibility of rupture

Ruptured aneurysm

Is a bursting of an aneurysm

can result in rapid, life threatening internal bleeding

Abdominal Aortic Aneurysm (AAA)

Signs & Symptoms “Tearing” abdominal or back pain Pulsating mass in midline of abdomen Unequal femoral pulses Syncope

AAA Treatment

Rapid transport High flow O2 Treat for shock

Other Considerations

other causes of chest pain

pacemakers defibrillator implants CABG – coronary artery bypass graft

RX for all

High flow oxygen

(ventilate patient if needed!) Position of comfort Rapid transport

medications

Lasix Digoxin Lanoxin Inderal

NTG = nitroglycerin

Cerebral Vascular Accidents

AKA

“Stroke”

“Brain Attack”

CVA - Cerebral Vascular Accidents

sudden change in neurological status caused by interference with blood supply to brain

obstructive hemorragic

CVA signs & symptoms

hypertension altered mental status hemiparesis & hemiparalysis headache, blurred vision one sided facial droop aphasia incontinence

Transient Iscemic Attack

TIA’s AKA “mini-stroke” can have symptoms of CVA

temporary

The end

Questions?