CARDIAC ASSESSMENT

Blood Flow thru Heart If you know this, it will help you with heart failure. Heart Failures is just a backward FLOW through the heart

Conduction System Electrical impulses that systematically depolarize the heart & begins in the SA node Synchronized r & l ventricular contraction Ejection of blood into pulmonary &systemic circulation Refractory period- resting state

Cardiac output CO = loc Starling’s Law= the greater the stretch, the more forceful the contraction Preload=volume of blood in the ventricles. This is increased by things like HTN, valve disease, hypervolemia Afterload= peripheral resistance against which the l ventricle must pump This is affected by size of the vent, wall tension, & Bp

Subjective data History of present illness Past health history Medications Lifestyle But if a patient is in severe pain or sob, must prioritize quickly to get the most info. may not have time to do a full health history P. 665 Table 31-1 = health history

Physical exam General appearance Inspection- skin for color, hair distribution, edema , veins in neck Palpation- pulses in the neck, upper & lower extremities, cap refill, heaves (lifts of the chest wall in the precordial area) Auscultation- S1= closure of tricuspid & mitral valves s2= closure of aortic & pulmonic valves Pulse deficit= Aortic, pulmonic & mitral area

Focused assessement P. 668 See assessment abnormalities & focused Assessment chart

Diagnostic tests Biomarkers: helpful in diagnosing acs, mi neg=less than 0.5mcg/l pos= greater than 2.3mcg/l Troponin: heart muscle protein released into circ. after cell death Ckmb Holter monitor (loop recorder) Homocysteine TEE C-reactive protein stress test/nuclear cardiology Lipids Good chart in book on labs/diag tests