The Incredible Heart

1
The Incredible Heart

• APL3
• Who sketched this?

2
Blood supply to the Heart

• Supplied to the heart muscle (myocardium) by the
  coronary arteries
• First 2 branches off the Aorta
• Supply Myocardium with constant supply of blood.
• Poorest ventricular contraction
• Best ventricular relaxation

3
Diagrams of Coronary vessels
4
Blocked Coronary Arteries (CAD)

• Angina Pectoris
• Blockage of blood flow to the heart
• Ischemia pain
• TX Nitroglycerine
• Sublingual, taken when pain occurs
• Taken 3x every 5 min

5
Myocardial Infarction (heart attack)

• Mortality 500K 700K per year in US
• CauseComplete obstruction of coronary artery
  leading to the heart
• Result death of heart tissue

• Signs Symptoms
• Persistent chest pain
• Tightness in chest
• Difficulty breathing
• Jaw, neck, shoulder pain (referred pain)
• Sweating

6
More MI

• 50 of MI deaths occur prehospital
• TX immediately take aspirin and get to hospital
• Sex Age 40-70 M
• After age 70 male/female comparable

• Mortality rates are declining over last several
  years
• WHY??

7
Hypertension

• High Blood Pressure
• Systolic BP Amount of pressure in the aorta
  during ventricular contraction
• Diastolic BP amount of pressure in the aorta
  during rest or atrial contraction.
• Normal was 120/80 mm/Hg. Now changed to 115/75
  mm/Hg.
• Puts added stress on heart and vessels

8
Thrombus

• Ex Coronary Thrombosis (blood clot)
• Build-up of plaque(atherosclerosis can narrow
  arteries for blood flow and clot forms or
• Rupture of plaque

9
(No Transcript)
10
(No Transcript)
11
Embolus

• Ex Pulmonary Embolism
• Obstruction caused from floating clot or bubble
  of gas
• Floating clot gets stuck and blocks all blood
  flow.

12
(No Transcript)
13
Congestive Heart Failure (CHF)

• Fx as a pump is impaired due to
• A. Diseases that weaken heart
• B. diseases causing stiffening of heart
• C. diseases that increase oxygen demand

14
Cerebral Vascular Accident (CVA/Stroke)

• Lack of blood supply to the brain that can result
  in a decrease in neurological/physical fx,
  caused by bleeding into the brain, or formation
  of a bloodclot that blocks an artery to the brain
  

15
Aneurysm

• An aneurysm (or aneurism) is a localized,
  blood-filled dilation (balloon-like bulge) of a
  blood vessel caused by disease or weakening of
  the vessel wall. Aneurysms most commonly occur in
  arteries at the base of the brain (the circle of
  Willis) and in the aorta (the main artery coming
  out of the heart), a so-called aortic aneurysm.
  The bulge in a blood vessel can burst and lead to
  death at any time. The larger an aneurysm
  becomes, the more likely it is to burst.

16
Quick Quiz- 10 points

• 1. Why can the same coronary artery be of a
  different level of importance from one person to
  another?
• 2. List 2 important interventions for someone who
  is suspected of having a myocardial infarction
• 3. Explain the connection between a thrombus and
  atherosclerosis

17
Questions cont.

• 4. Describe what CHF is and what treatments are
  usually done for it
• 5. List 3 things that you would have a person
  suspected of having a CVA do. Why would you do
  this?