CIRCULATION

Ulysses John P. Almocera, RN, EMT

HEART
pumps blood through the arteries, capillaries, and veins located in the thoracic cavity between the lungs (mediastinum) Beats 60-100 times a minute

LAYERS OF THE HEART

Endocardium Lines the inside of the hearts chambers and great vessels Myocardium Contains the muscle cells that form the bulk of the heart and contracts with each beat Epicardium/visceral Pericardium Outermost layer of the heart Parietal Pericardium Serves to protect the heart and anchor it to sorrounding tissues

CORONARY CIRCULATION
The muscles of the heart are supplied with blood by the coronary circulation Coronary arteries fill during ventricular relaxation If the coronary arteries are blocked, the myocardium is deprived with oxygen, and the patient may develop chest pain (angina)

CARDIAC CYCLE
SYSTOLE
The heart ejects (propels) the blood into the pulmonary and systemic circulations

DIASTOLE
The ventricles fill with blood

ATRIAL KICK
At the end of the diastolic phase, the atria contracts, adding an additional volume to the ventricles

FACTORS RELATED TO CARDIAC FUNCTION

Amount of blood ejected from the heart CARDIAC OUTPUT each minute; CO= SVx HR STROKE VOLUME HEART RATE CONTRACTILITY PRELOAD AFTERLOAD Amount of blood ejected from the heart with each beat Number of beats per minute Inotropic state of the myocardium, strength of contraction Left ventricular end diastolic volume, stretch of the myocardium Resistance against which the heart must pump

CHAMBERS OF THE HEART

Right atrium (RA)
Receives deoxygenated blood from the body by way of the superior and inferior caval veins

Right ventricle (RV)

Pumps blood to the lungs by way of the pulmonary artery

Left atrium (LA)

Receives oxygenated blood from the lungs by way of the four pulmonary veins

Left ventricle (LV)

Pumps blood to the body by way of the aorta

HEART VALVES
Tricuspid valve Right AV valve; prevents backflow of blood from the RV to the RA when the RV contracts Pulmonary semilunar valve Prevents backflow of blood from the pulmonary artery to the RV when the RV relaxes Mitral valve Left AV valve; prevents backflow of blood from the LV to the LA when the LV contracts Aortic semilunar valve Prevents backflow of blood from the aorta to the LV when the LV relaxes

CARDIAC CONDUCTION PATHWAY

cardiac cycle is a sequence of mechanical events that is regulated by the electrical activity of the myocardium. nerve impulses are not required to cause contraction

Sinoatrial (SA) node

specialized group of cardiac muscle cells located in the wall of the right atrium just below the opening of the superior vena cava (60 to 100 times per minute)

BLOOD Transports oxygen, nutrients, and hormones to cells, and metabolic wastes from the tissues for elimination Regulates body temperature, pH, and fluid volume Prevents infection and blood loss

RISK FACTORS FOR CORONARY HEART DISEASE

NONMODIFIABLE RISK FACTORS Heredity

Genetic predisposition

Age
60 and above

Gender
Womens risk increase at menopause Men during their 40s and 50s

MODIFIABLE RISK FACTORS

Elevated serum lipid level Hypertension Cigarette smoking Diabetes Obesity Sedentary lifestyle

OTHER RISK FACTORS

Heat and cold Previous health status Stress and coping Dietary factors Alcohol intake

ALTERATIONS IN CARDIOVASCULAR FUNCTION

DECREASED CARDIAC OUTPUT

Myocardial Infaction
Also known as heart attack Manifested by:
Chest pain Substernal pain Nausea Shortness of breath Diaphoresis

HEART FAILURE
May develop if the heart is not able to keep up with the bodys need for oxygen and nutrients to the tissues Manifestations
Pulmonary congestion Shortness of breath Increased heart rate Increased respiratory rate Distended neck veins

IMPAIRED TISSUE PERFUSION

ISCHEMIA
Lack of blood supply due to obstructed circulation Obstruction causes myocardial ischemia, often resulting to angina pectoris If cerebral vessels affected, the result may be a transient ischemic attack or a stroke

IMPAIRED PERIPHERAL CIRCULATION

Decreased peripheral pulses Pale skin color Cool extremities Deceased hair distribution

PROMOTING A HEALTHY HEART Exercise regularly Do not smoke Maintain your ideal weight Low fat diet Drink alcohol in moderation Reduce stress, anger management