disorders of cardiac function

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).