Disorders That Affect the Whole Heart
Pericardial disorders
Coronary heart disease
Myocardial diseases
These disorders can cause symptoms of both right- and left-sided heart failure
surrounds the heart
pericardium
Pericarditis
Inflammation of the pericardium
Pain.
Exudate brings on
=Serous - pericardial effusion
==Cardiac tamponade
=Fibrous- friction rub; adhesions
ECG changes
causes of pericarditis
rapid accumulation of exudate compresses the heart brought on by serous or pericardial effusion from pericarditis
Cardiac tamponade
Inflammation of the pericardium may restrict the heart's movement due to:
Serous exudate filling the pericardial cavity (pericardial effusion) and
Fibrous scar tissue making the pericardium stick to the heart (constrictive pericarditis)
pericardial effusion
serous exudate filling pericardial cavity.
restricts heart movement
constrictive pericarditis
fibrous scar tissue making the pericardium stick to the heart
restrict hearts movement
restricts heart expansion
fluid in pericardial cavity
when heart expansion is restricted the
left and right ventricles cannot accept enough blood
when left ventricle cannot receive enough blood, it results in
decreased cardiac output, and decreased blood pressure and shock
when right ventricle cannot receive enough blood, it results in
increased venous pressure, and
jugular distention
consequences of pericardial effusion
fluid in pericardial cavity
restricts heart expansion
left and right ventricles cannot accept enough blood
left-decreased cardiac output, and decreased blood pressure and shock
right-increased venous pressure, and
jugular distention
What is the immediate treatment for severe cardiac tamponade?
Pericardiocentesis (removal of fluid from the sac with a needle)
because there is so much fluid in the pericardial sac compressing the heart that its function declines rapidly. The fluid must be removed quickly by inserting a needle into the pericardial s
Pulsus Paradoxus
On inhaling, the right ventricle fills with extra blood
Because the heart cannot expand fully when the right ventricle is overfilled, the left ventricle is compressed and cannot accept much blood
On the next heartbeat, the left ventricle does not send out
Coronary Heart Disease
Atherosclerosis blocks coronary arteries
Ischemia from coronary heart disease may cause
Angina
Heart attack
Cardiac arrhythmias
Conduction deficits
Heart failure
Sudden death
Imbalance in blood supply and the heart's demands for oxygen. less blood and higher oxygen demand
Chronic Ischemic Heart Disease
Chronic Ischemic Heart Disease less blood
Atherosclerosis
Vasospasm
Thrombosis
Chronic Ischemic Heart Disease higher oxygen demand
Stress
Exercise
Cold
Kinds of Angina
Stable angina.
Variant .
Silent myocardial ischemia
Pain when heart's oxygen demand increases
Stable angina
Pain when coronary arteries spasm
Variant angina
Myocardial ischemia without pain
Silent myocardial ischemia
ECG changes and Serum cardiac markers
Acute Coronary Syndromes
T-wave inversion
ST-segment depression or elevation
Abnormal Q wave
ECG Changes
Proteins released from necrotic heart cells
Myoglobin, creatine kinase, troponin
Serum cardiac markers
myoglobin, creatine kinase, troponin
protein serum cardiac markers released from necrotic heart cells during acute coronary syndromes
Chronic ischemic heart disease is more likely to result in stable angina than acute coronary syndromes
true Ischemic heart disease is characterized by stable angina, which is associated with plaques that are fixed obstructions. Unstable angina is characterized by plaques with platelets stuck to them (these are likely to form a thrombus)�they cause a range
Acute Myocardial Infarction
Chest pain.
-Severe, crushing, constrictive, OR like heartburn.
Sympathetic nervous system response
-GI distress, nausea, vomiting
-Tachycardia and vasoconstriction
-Anxiety, restlessness, feeling of impending doom
Hypotension and shock
-Weakness in arms
An Acute MI (AMI) Leaves Behind an Area of
Yellow Necrosis
Complications of AMI
Heart failure
Cardiogenic shock
Pericarditis
Thromboemboli
Rupture of the heart
Ventricular aneurysms
Malfunctioning heart muscle can cause heart failure if:
Ventricles are unusually thick so there is not a normal amount of room for blood inside them (hypertrophic cardiomyopathy)
Ventricles are too stiff to stretch (restrictive cardiomyopathy)
Ventricles are too weak to pump out the blood that is in them (MI,
Myocarditis
Cardiomyopathies
-Dilated cardiomyopathies
-Hypertrophic cardiomyopathies
-Restrictive cardiomyopathies
-Peripartum cardiomyopathy
Myocardial Disorders
Defects in their contractile proteins make cells too weak
They hypertrophy to do the same amount of work as normal cells
Need more oxygen and perform less efficiently, so the person is prone to heart failure and may suffer sudden death during exertion
Hypertrophic Cardiomyopathy
Which type of cardiomyopathy is characterized by weakened ventricles?
dilated cardiomyopathy, the ventricles are too weak to pump blood, resulting in a diminished cardiac output (CO).
By interfering with normal blood flow, these often cause the signs and symptoms of left- or right-sided heart failure
Valvular Disorders and Heart Defects
The endocardial structures lining the heart can cause
heart failure
If the AV valves leading into the ventricles do not work
mitral or tricuspid problems
If the semilunar valves leading out of the ventricles do not work
aortic or pulmonary problems
Each of the____ valves can be defective
four
valve will not open all the way; it is harder to force blood through it
Stenosis
valve will not close all the way; it leaks when it should be closed
Regurgitation
Tell whether the following statement is true or false.
Mitral valve regurgitation results in a diminished stroke volume.
True
If the mitral valve does not close as it should, a portion of the stroke volume (amount of blood ejected by the ventricle/beat) leaks back into the left atrium, decreasing the amount of blood that is ejected during that beat (SV).