1. Cardiovascular System

2. Structures Heart-pump Arteries, veins, and capillaries-carries blood
Lymph system-returns excess fluid

3. Function of the Cardiovascular System
Transport nutrients and oxygen to the body
Transport waste products from the cells to the kidneys to be excreted
Distribute hormones and antibodies throughout the body
Help control body temperature & maintain electrolyte imbalance

4. Heart Two sided double pump Weighs less than a pound
Slightly larger than a fist
5 inches in length
Located between lungs
Slightly left of sternum

5. Heart

6. Heart When heart stops beating: Life stops
Lose consciousness after 5 seconds without oxygen
After seconds, muscle twitches
After 4-5 minutes, brain cells begin to die and cannot be replaced.

7. Heart Terms Apex-conical tip-bottom of heart Base- topmost (superior)
Atrium-top chambers of heart
Ventricles-bottom chambers of heart

8. Heart Right side of heart Pumps deoxygenated blood to the lungs
Carbon dioxide is exchanged
Pulmonary Circulation
Left side of heart
Pumps oxygenated blood throughout the body
Systemic Circulation

10. Hepatic Circulation
Path of blood from the intestines, gallbladder, pancreas, stomach, and spleen through the liver.
Liver
Stores and modifies nutrients through liver
Removes or alters toxic substances so can be eliminated through urinary system

11. Anatomy Atria Ventricles Septum Superior/Inferior Vena Cava
Coronary Sinus
Pulmonary Artery
Pulmonary Veins
Aorta
Atrioventricular valves-separate atria/ventricles
Semilunar valves-separate ventricles from outgoing vessels (pulmonary artery/aorta)

12. Anatomy Continued
Tricupsid Valve
Bicupsid valve
Pulmonary Semilunar Valve
Aortic semilunar valve

14. Anatomy of Heart

15. Cardiac Tissue Endocardium-lines inside of heart-smooth
Myocardium-thickest layer-muscle
Pericardium-double membrane-provides lubrication between heart and surrounding tissues
Pericardial Sac

16. Blood Flow

17. Cardiovascular-day 2
Chapter 11

18. Heart Activity Controlled by autonomic nervous system Hormones
Fluid balance
Only muscle tissue to create its own stimulation

19. Electrical Nodes
The heart is the only muscle that can stimulate its own contractions
Sinoatrial (SA) cells in the right atrium start the heart –AKA pacemaker
Atrioventricular (AV) node sends an impulse into lower portions of the heart
AV bundle or bundle of His stimulates the Purkinje fibers
Purkinje fibers cause the ventricles to contract

20. Blood Vessels Veins Arteries Capillaries Carries blood to the heart
Carry deoxygenated blood
Except for pulmonary
Dark red
Arteries
Carries blood away from the heart
Carries oxygenated blood
Bright red
Capillaries
Exchanges oxygen/CO2/nutrients

21. Average blood volume is 5-6 L
Beats 86,000 to 144,000 times each day
All blood is circulated in one
minute

22. Two arteries that branch off ascending aorta
Coronary Arteries
Two arteries that branch off ascending aorta
Provide blood supply to heart

23. Assessment Techniques
Measuring pulse and blood pressure
Listening to heart sounds
Determining cardiac output
Measuring muscle activity with electrocardiography
Inserting a cardiac catheter
Using echocardiography
Health care workers assess the activity of the heart as an indicator of overall body condition.

24. Assessment Techniques (Cont.)
Pulse
Surge of blood against the walls of the arteries
Eight pulse points on the body
Normal pulse rate for adults is 60 to 90 beats/min
Blood pressure
Force of blood against the walls of the arteries
Systolic pressure
Ventricles of the heart contract
Diastolic pressure
Ventricles relax
Normal blood pressure
120/80 mm Hg
Varies greatly among people
A healthy systolic pressure is usually less than 120 mm Hg. Diastolic pressure should be less than 90 mm Hg.

25. Assessment Techniques (Cont.)
Heart sounds
Lub-dub sound of the heart
Results from opening and closing of the valves
Heard through a stethoscope
Murmurs
Abnormal or extra sound
May be benign or indicate a disorder
Thrill
Vibration felt by touch over an artery
Caused by an abnormal flow of blood
When you listen to your heart through a stethoscope, the beats you hear are the valves slamming shut.

26. Assessment Techniques (Cont.)
Electrocardiography
The pattern of electrical activity in heart contractions is measured graphically
Normal and abnormal heart activities have characteristic wave patterns
Each section of the electrocardiogram pattern indicates a specific part of the heart’s electrical activity.

27. EKG
Figure 14-8 shows a normal electrocardiogram pattern with descriptions.
From Grauer K: A practical guide to ECG interpretation, ed 2, St. Louis, 1998, Mosby.

28. Assessment Techniques (Cont.)
Cardiac catheterization
A catheter is used to measure the pressure in the chambers of the heart, to take blood samples, and to view obstructions in the vessels
A tube is inserted through the blood vessels into the heart
Dye is then released and traced using x-ray imaging
To allow viewing of an image of the inside of the arteries, ultrasound transducers are inserted into the tip of the catheter.

29. Assessment Techniques (Cont.)
Echocardiography (ECHO)
Uses ultrasonic waves to show the structures and motions of the heart
Transducer plots the sound echoes to produce a graphic picture
During a transoesophageal echocardiography, the back of the throat is numbed.

30. Disorders of the Cardiovascular System
Aneurysm
Area of a blood vessel that bulges because of a weakness in the wall
Atherosclerosis
Narrowing of blood vessels caused by deposits of fatty material containing calcium and cholesterol
Cardiac arrhythmia
Disturbance of the heart’s rhythm caused by a defect in the heart’s pacemaker cells or by damage to heart tissue
Most aneurysms occur in the aorta, but they can occur in other vessels.
Atherosclerosis is sometimes called hardening of the arteries; it can occur in any part of the body.

31. Disorders of the Cardiovascular System (Cont.)
Cardiovascular disease
General term for the combined effects of arteriosclerosis and atherosclerosis
Conditions called coronary artery disease (CAD)
CAD may manifest as:
Heart attack
Peripheral artery disease (PAD)
Angina
Stroke
Cardiovascular disease is responsible for more than 29% of all deaths in the United States.
CAD is the leading cause of death of men and women in the United States.
Discuss prevention and treatment of CAD.

32. Disorders of the Cardiovascular System (Cont.)
Congenital heart disease
A group of disorders that affect about one in eight newborns each year in the United States
Defects include
Narrowing of vessels (stenosis) to the heart and atrial or ventricular septal defects
Coarctation of the aorta and patent ductus arteriosus (opening between the pulmonary artery and aorta that does not close at birth)
Describe and discuss symptoms of and treatment for congenital heart disease.

33. Disorders of the Cardiovascular System (Cont.)
Congestive heart failure (CHF)
Inability of the heart to pump blood adequately to meet the body’s needs
Right sided failure-caused fluid build up in the body, especially lower extremities
Left sided failure-causes fluid build up in the lungs
Usually caused by disease in another body system
Leads to inadequate respiratory and kidney function
CHF may occur suddenly or over a period of time.
Discuss symptoms and treatment of CHF.

34. Disorders of the Cardiovascular System (Cont.)
Hypertension
High blood pressure
Primary hypertension
Cause of hypertension unknown
Secondary hypertension
Hypertension caused by other conditions, such as kidney disease and adrenal disorders
Hypertension occurs in about 1 in 5 people in the United States.
Discuss symptoms and treatments for hypertension.

35. Disorders of the Cardiovascular System (Cont.)
Myocardial infarction
AKA heart attack
Results from blockage of the blood vessels to the heart by a clot (embolism)
Cardiac arrest
Occurs when large area of the heart is affected and may stop functioning
Describe symptoms and treatment for myocardial infarction.

36. Disorders of the Cardiovascular System (Cont.)
Phlebitis
Inflammation of a vein, often with formation of a clot (thrombus)
Results from damage to the vessel wall or prolonged sitting or standing
If thrombus breaks free, it may lodge in a small artery and cause tissue damage or sudden death
Discuss symptoms and treatment for phlebitis.

37. Disorders of the Cardiovascular System (Cont.)
Rheumatic heart disease
A condition in which the heart muscle and valves are damaged by a recurrent bacterial infection that usually begins in the throat
Bacteria produces a toxin that causes inflammation and damage to the heart valves
Varicose veins
A condition in which veins become enlarged and ineffective
Explain the term rheumatic.
Rheumatic heart disease is most common in children between the ages of 5 and 15.
Discuss the symptoms of and treatment for rheumatic heart disease.
Discuss the appearance of varicose veins.

38. Issues and Innovations
Heart replacement and transplants
1967: First heart replacement
Approximately 2000 heart transplantations are performed each year in the United States
First artificial heart, the Jarvik-7, was connected to an external power source and pump
2001: AbioCor self-contained artificial heart
Designed to extend life for people with end-stage heart failure who had no other clinical options
Helps provides a good quality of life
The older mechanical hearts required the patient to be attached to a large console that required that the patient be essentially bedridden.

39. Issues and Innovations (Cont.)
Figure 14-11, B, shows the placement of AbioCor heart in the body.
Courtesy ABIOMED, Inc., Danvers, Mass.

40. Issues and Innovations (Cont.)
The U.S. Food and Drug Administration (FDA) approved use of the SynCardia Temporary Total Artificial Heart in 2005
Used in patients with irreversible failure of the ventricles
Designed to support life functions until a transplant becomes available
In 2014, the 1300th implant of the SynCardia total artificial heart was performed
The goal of SynCardia CardioWest Temporary Total Artificial Heart (TAH) is to develop smaller, more portable devices.

41. Issues and Innovations (Cont.)
Cholesterol controversy
Waxlike substance
Used in body to make:
Cell membranes
Hormones
Vitamin D
Carried by proteins (lipoproteins)
Found in two lipoprotein forms
High-density lipoprotein (HDL)
Takes cholesterol to the liver
Low-density lipoprotein (LDL)
Blocks the arteries
Cholesterol does not mix in water.
An elevated blood cholesterol level is one of the major risk factors for development of heart disease.
More than 50% of heart attacks and almost 20% of strokes are linked to high cholesterol levels.
HDL should be greater than 40 mg/dL.
LDL should be less than 100 mg/dL.
Triglycerides should be less than 150 mg/dL.
A lipoprotein profile every 5 years or more often is recommended.

42. Issues and Innovations (Cont.)
Cholesterol controversy
In 2013, the American Heart Association and American College of Cardiology released new guidelines on cholesterol management
A calculator of risk for developing atherosclerotic cardiovascular disease uses nine pieces of information
Gender
Age
Race
Total cholesterol
HDL
Systolic BP
Current treatment for high pressure
Diabetes
Smoking
Prescribing a statin medication to reduce cholesterol is recommended for anyone with cardiovascular disease.

43. Issues and Innovations (Cont.)
Harvard research study: LDL versus HDL cholesterol
Type of fat, not amount, changes cholesterol level
Limit intake of saturated fats, and eliminate trans-fats
Monounsaturated and polyunsaturated fats were determined to lower LDL and raise HDL levels
Olives, canola oil, avocados, fish, and most nuts
Saturated fats raise LDL and HDL levels
Whole milk, butter, cheese, red meat, chocolate, and coconut oil
Trans fats are the worst fats
Margarines, vegetable oils, shortening, and most fast foods
Discuss ways to increase HDLs and lower LDLs.
Discuss ways to decrease amount of saturated fats and eliminated trans fats in your diet.
Discuss treatment for high cholesterol.