2. The Cardiovascular System & Cardiovascular Emergencies

3. Supplies oxygenated blood to all cells in the body!!

4. 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

5. 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

6. 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

7. Path of blood flow (Systemic circulation) left ventricle aorta arteries, arterioles, capillaries, etc... Vena cava (superior and inferior) Right atrium

8. Path of blood flow (Pulmonary circulation) right ventricle pulmonary artery lung ( pulmonary capillaries) Pulmonary veins Left atrium

9. The Circulatory System

10. Blood Flow Through the Heart

12. The Heart Electrical System independent stimulates contractions of heart normally initiated in right atrium if initiated from other areas = abnormal

13. Electrical Conduction Sinoatrial (SA) node Atrioventricular node Bundle of His (AV bundle) Bundle branches Purkinje fibers

14. Vessels Arteries Arterioles Capillaries Veinioles Veins

15. Vessels Vasoconstriction Effect on Blood Pressure? Vasodilation Effect on Blood Pressure?

16. Major Arteries and Veins Aorta Pulmonary Carotid Femoral Brachial Radial Superior vena cava Inferior vena cava Pulmonary Look Up in TEXT!

17. 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

18. Blood Liquid Portion - Plasma Solid Portion Red blood cells White blood cells Platelets

19. Blood Plasma - transports solids It is basically a salt solution

20. Blood Red Blood cells - carry oxygen AKA - Erythrocytes Hemoglobin is the substance that combines with oxygen in a red blood cell

21. Blood White Blood cells - fight infection AKA Leukocytes almost all blood cells (red or white) are made in the bone marrow.

22. Blood Platelets – are essential for formation of blood clots. They perform coagulation. AKA - thrombocytes

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

24. note Systemic Vs pulmonary circulation Pulmonary artery Pulmonary vein Coronary arteries Pericardium Myocardium

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

26. You get…Perfusion Definition – Adequate flow of blood through body tissue or organs to meet the needs of the cell.

27. Cardiovascular Emergencies

28. Abnormal Heart Conditions Angina Pectoris Myocardial Infarction Congestive Heart Failure

29. 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

30. 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

31. 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

32. there are always exceptions... Referred pain Atypical pain No pain

33. Congestive Heart Failure Causes diseased heart valves and damaged ventricles Chronic hypertension obstructive pulmonary disease (emphysema, chronic bronchitis) often a complication of an MI

34. 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

35. Signs & Symptoms of CHF Pedal edema JVD Ascites

36. Critical CHF & Pulmonary Edema dyspnea rales & audible rales pink frothy sputum tachycardia cyanosis anxiety, restlessness

37. Vascular emergencies Atherosclerosis & arteriosclerosis Thrombus Embolus Aneurysm

38. Athero/arterio -sclerosis build up of fatty deposits & calcium causes narrowing of the lumen can create rough inner surface that can lead to clot

39. Athero/arterio -sclerosis Results in: restricted blood flow high blood pressure AMI

40. 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

41. 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

42. Aneurysm is a ballooning out of a weakened section of an artery Possibility of rupture

43. Ruptured aneurysm Is a bursting of an aneurysm can result in rapid, life threatening internal bleeding

44. Abdominal Aortic Aneurysm (AAA) Signs & Symptoms “Tearing” abdominal or back pain Pulsating mass in midline of abdomen Unequal femoral pulses Syncope

45. AAA Treatment Rapid transport High flow O2 Treat for shock

46. Other Considerations other causes of chest pain pacemakers defibrillator implants CABG – coronary artery bypass graft

47. RX for all High flow oxygen (ventilate patient if needed!) Position of comfort Rapid transport

48. medications Lasix Digoxin Lanoxin Inderal NTG = nitroglycerin

49. Cerebral Vascular Accidents AKA “Stroke” “Brain Attack”

50. CVA - Cerebral Vascular Accidents sudden change in neurological status caused by interference with blood supply to brain obstructive hemorragic

51. CVA signs & symptoms hypertension altered mental status hemiparesis & hemiparalysis headache, blurred vision one sided facial droop aphasia incontinence

52. Transient Iscemic Attack TIA’s AKA “mini-stroke” can have symptoms of CVA temporary

53. The end Questions?