The Cardiovascular System

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TheCardiovascular System

• Cardiovascular Emergencies

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Supplies oxygenated blood to all cells in the
body!!
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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

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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

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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

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Path of blood flow (Systemic circulation)

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

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Path of blood flow (Pulmonary circulation)

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

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The Circulatory System
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Blood Flow Through the Heart
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The Heart

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

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Electrical Conduction

• Sinoatrial (SA) node
• Atrioventricular node
• Bundle of His
• (AV bundle)
• Bundle branches
• Purkinje fibers

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Vessels

• Arteries
• Arterioles
• Capillaries
• Veinioles
• Veins

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Vessels

• Vasoconstriction
• Effect on Blood Pressure?
• Vasodilation
• Effect on Blood Pressure?

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Major Arteries and Veins

• Aorta
• Pulmonary
• Carotid
• Femoral
• Brachial
• Radial

• Superior vena cava
• Inferior vena cava
• Pulmonary

Look Up in TEXT!
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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

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Blood

• Liquid Portion - Plasma
• Solid Portion
• Red blood cells
• White blood cells
• Platelets

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Blood

• Plasma - transports solids
• It is basically a salt solution

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Blood

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

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Blood

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

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Blood

• Platelets are essential for formation of blood
  clots. They perform coagulation.
• AKA - thrombocytes

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

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

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

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You getPerfusion

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

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Cardiovascular Emergencies
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Abnormal Heart Conditions

• Angina Pectoris
• Myocardial Infarction
• Congestive Heart Failure

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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

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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

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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

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there are always exceptions ...

• Referred pain
• Atypical pain
• No pain

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Congestive Heart Failure

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

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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

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Signs Symptoms of CHF

• Pedal edema
• JVD
• Ascites

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Critical CHF Pulmonary Edema

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

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Vascular emergencies

• Atherosclerosis arteriosclerosis
• Thrombus
• Embolus
• Aneurysm

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Athero/arterio -sclerosis

• build up of fatty deposits calcium
• causes narrowing of the lumen
• can create rough inner surface that can lead to
  clot

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Athero/arterio -sclerosis

• Results in
• restricted blood flow
• high blood pressure
• AMI

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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

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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

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Aneurysm

• is a ballooning out of a weakened section of an
  artery
• Possibility of rupture

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Ruptured aneurysm

• Is a bursting of an aneurysm
• can result in rapid, life threatening internal
  bleeding

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Abdominal Aortic Aneurysm (AAA)

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

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AAA Treatment

• Rapid transport
• High flow O2
• Treat for shock

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Other Considerations

• other causes of chest pain
• pacemakers
• defibrillator implants
• CABG coronary artery bypass graft

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RX for all

• High flow oxygen
• (ventilate patient if needed!)
• Position of comfort
• Rapid transport

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medications

• Lasix
• Digoxin
• Lanoxin
• Inderal
• NTG nitroglycerin

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Cerebral Vascular Accidents

• AKA
• Stroke
• Brain Attack

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CVA - Cerebral Vascular Accidents

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

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CVA signs symptoms

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

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Transient Iscemic Attack

• TIAs
• AKA mini-stroke
• can have symptoms of CVA
• temporary

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The end

• Questions?