The
Cardiovascular System

& Cardiovascular Emergencies

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Supplies oxygenated blood to

all cells in the body!!

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Components

Heart pumps bloodVessels Arteries carry blood away from the heart and veins carry blood back to the heartBlood fluid that carries nutrients essential to cell function

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The Heart

Located in the thoracic cavity2nd intercostal space at right sternal border5th intercostal space at left midclavicular lineabout size of your clenched fistIn mediastinum

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The Heart

4 chambers2 sided - divided by septum2 upper called atria2 lower called ventriclessurrounded by pericardiumsystem of one way valves

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Path of blood flow (Systemic circulation)

left ventricleaortaarteries, arterioles, capillaries, etc ...Vena cava (superior and inferior)Right atrium

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Path of blood flow (Pulmonary circulation)

right ventriclepulmonary arterylung ( pulmonary capillaries)Pulmonary veinsLeft atrium

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The Circulatory System

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Note that text on graphic may be difficult to read.

Blood Flow Through the Heart

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The Heart

Electrical Systemindependentstimulates contractions of heartnormally initiated in right atrium if initiated from other areas = abnormal

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Electrical Conduction

Sinoatrial (SA) nodeAtrioventricular nodeBundle of His

(AV bundle)

Bundle branchesPurkinje fibers

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Vessels

ArteriesArteriolesCapillariesVeiniolesVeins

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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 - PlasmaSolid PortionRed blood cellsWhite blood cellsPlatelets

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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 circulationPulmonary arteryPulmonary veinCoronary arteriesPericardiumMyocardium

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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 PectorisMyocardial InfarctionCongestive Heart Failure

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Angina Pectoris

Decreased blood flow to heart muscle results in ischemia- lack of oxygenCauses mild to moderate painPain may radiateUsually 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 tissuemay not be provokedmoderate to severe painCan last between 30 minutes and several hoursMay not go away with rest, O2 or nitroglycerinImmediate transport is essential

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AMI

Signs and SymptomsSudden onset of weakness, nausea, and diaphoresisChest pain or discomfortdyspneairregular pulsePain in lower jaw, arms, or backSudden faintingPulmonary edemaSudden deathFeeling of impending doom

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there are always exceptions ...

Referred painAtypical painNo pain

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Congestive Heart Failure

Causesdiseased heart valves and damaged ventriclesChronic hypertensionobstructive pulmonary disease (emphysema, chronic bronchitis)often a complication of an MI

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CHF

Heart tries to compensate.Increased heart rateEnlarged left ventricleThe 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 edemaJVD Ascites

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Critical CHF & Pulmonary Edema

dyspnearales & audible ralespink frothy sputumtachycardiacyanosisanxiety, restlessness

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Vascular emergencies

Atherosclerosis & arteriosclerosisThrombusEmbolusAneurysm

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Athero/arterio -sclerosis

build up of fatty deposits & calciumcauses narrowing of the lumencan create rough inner surface that can lead to clot

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Athero/arterio -sclerosis

Results in: restricted blood flowhigh blood pressureAMI

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Thrombus

formation of clot and debris in vessels from plaquecan become large enough to occlude vesselpartial blockage = distal reduction of O2complete blockage = distal tissue death

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Embolus

a thrombus that breaks off from vessel wall.flows through blood vesselsmay partially or completely occlude smaller arteryocclusion 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 arteryPossibility of rupture

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Ruptured aneurysm

Is a bursting of an aneurysmcan result in rapid, life threatening internal bleeding

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Abdominal Aortic Aneurysm (AAA)

Signs & SymptomsTearing abdominal or back painPulsating mass in midline of abdomenUnequal femoral pulsesSyncope

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AAA Treatment

Rapid transportHigh flow O2Treat for shock

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Other Considerations

other causes of chest painpacemakersdefibrillator implantsCABG coronary artery bypass graft

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RX for all

High flow oxygen

(ventilate patient if needed!)

Position of comfortRapid transport

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medications

LasixDigoxinLanoxinInderalNTG = 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 brainobstructivehemorragic

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CVA signs & symptoms

hypertensionaltered mental statushemiparesis & hemiparalysisheadache, blurred visionone sided facial droopaphasiaincontinence

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Transient Iscemic Attack

TIAsAKA mini-strokecan have symptoms of CVAtemporary

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The end

Questions?

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