second to pump blood throughout the body. It also has an extensive electrical system that initiates and coordinates its contractions.
chamber; chamber in the brain)
three triangular cusps (leaflets). As the right atrium contracts, the tricuspid valve opens to allow blood to flow into the right ventricle. Then it closes to prevent blood from flowing back into the right atrium.
trunk. As the right ventricle contracts, the pulmonary valve opens to allow blood to flow into the pulmonary trunk and pulmonary arteries. Then it closes to prevent blood from flowing back into the right ventricle.
cusps and is also known as the bicuspid valve. As the left atrium contracts, the mitral valve opens to allow blood to flow into the left ventricle. Then it closes to prevent blood from flowing back into the left atrium.
shaped central area between the lungs.
known as arterioles.
of a capillary is so small that blood cells must pass through in single file. Capillaries are the connecting structures between arterioles and venules.
the ascending aorta.
artery, which brings oxygenated blood to the upper arm, and then into the radial artery and ulnar artery, which bring oxygenated blood to the lower arm
cavity. These include the stomach, liver, gallbladder, pancreas, spleen, small intestine, large intestine, adrenal glands, kidneys (the renal arteries), ovaries (in a woman), testes (in a man), and the lower spinal cord.
the ____________ ______.
the lower leg.
and legs, but not the lungs) to the right atrium.
rior vena cava
everywhere in the body, except in the lungs.
going to, within, and coming from the lungs.
In right-sided congestive heart failure, the right ventricle is unable to adequately pump blood. Blood backs up in the superior vena cava, causing jugular venous distention (dilated jugular veins in the neck). Blood also backs up in the inferior vena cava, causing hepatomegaly (enlargement of the liver) and peripheral edema in the legs, ankles, and feet. Lung disease and increased pressure in the lungs cause the right ventricle to become enlarged; this condition is cor pulmonale. In left-sided congestive heart failure, the left ventricle is unable to
adequately pump blood. The blood backs up into the lungs, causing pulmonary congestion and edema that can be seen on a chest x-ray. There is also shortness of breath, cough, and an inability to sleep while lying flat. Treatment: Diuretic drug, digitalis drug, and antihypertensive drug. Severe left-sided heart failure is life-threatening; it may require surgery for a heart transplant or a left ventricular assist device (LVAD).
necrosis. If the area of necrosis is small, it will eventually be replaced by scar tissue. If the area is large, the heart muscle may be unable to contract and the patient will die. Also known as a heart attack. Treatment: Baby aspirin taken to prevent an MI or at the first sign of an MI. Thrombolytic drug to dissolve a clot during an MI.
Acute endocarditis causes a high fever and shock, while subacute bacterial endocarditis (SBE) causes fever, fatigue, and aching muscles. Treatment: Antibiotic drug.
mild murmurs that are not associated with disease and are not clinically significant. Treatment: Surgery to correct the defective heart valve (valvuloplasty), if needed.
is given prior to any dental or surgical procedure that might release bacteria that could further damage the valves. Valve replacement surgery, if needed.
Electrocardiography is performed to diagnose the type of arrhythmia. Treatment: Antiarrhythmic drug, cardioversion, or insertion of a pacemaker, depending on the type of arrhythmia.
progress to fibrillation. Treatment: Antiarrhythmic drug; cardioversion.
heart block, only some of the electrical impulses reach the ventricles. In third-degree heart block (complete heart block), no electrical impulses reach the ventricles. In right or left bundle branch block, the electrical impulses are unable to travel down the right or left bundle of His.
Treatment: Antiarrhythmic drug. Surgery to insert a pacemaker.
contractions (PACs) and premature ventricular contractions (PVCs). A repeating pattern of one premature contraction followed by one normal contraction is bigeminy. A repeating pattern of one premature
contraction followed by two normal contractions is trigeminy. Two premature contractions occurring together is a couplet. Treatment: Antiarrhythmic drug. Surgical insertion of a pacemaker.
(SA) node. Atrial tachycardia occurs when an ectopic site somewhere in the atrium produces an electrical impulse that overrides the SA node rhythm. Supraventricular tachycardia occurs when an ectopic site superior to the ventricles produces an electrical impulse. Paroxysmal
tachycardia is an episode of tachycardia that occurs suddenly and then goes away without treatment. Treatment: Antiarrhythmic drug. Cardioversion. Surgery to insert a pacemaker.
cardiac arrest. Treatment: Cardiopulmonary resuscitation (CPR).
This can be congenital or where arteriosclerosis has damaged the artery. With each heartbeat, the weakened artery wall balloons outward. An aneurysm can rupture without warning. A dissecting aneurysm is one that enlarges by tunneling between the layers of the artery wall. Treatment: Placement of a metal clip on the neck (narrowest part) of a small aneurysmal dilation to occlude the blood flow. Surgical excision of a large aneurysm and replacement with a synthetic tubular graft.
blood deposit cholesterol and form an atheroma or atheromatous plaque. Collagen fibers form underneath the plaque, so that the artery wall becomes hard and nonelastic. An artery with arteriosclerosis is said to be arteriosclerotic. This is also known as arteriosclerotic cardiovascular disease (ASCVD). Fatty plaque deposits enlarge more rapidly in patients who eat high-fat diets, have diabetes mellitus, or have a genetic predisposition
(family history). As plaque grows on an artery wall, it makes the . This condition is atherosclerosis. Pieces of atheromatous plaque easily break off, travel through the blood, and block other arteries. The rough edges of the
plaque can trap red blood cells and form a blood clot.
the carotid arteries to the brain, this can cause a stroke. In the coronary arteries to the heart muscle, this can cause angina pectoris and a myocardial infarction. In the renal arteries to the kidney, this can cause kidney failure. Treatment: Lipid-lowering drug. Surgery: Angioplasty or
stent to press down the plaque or endarterectomy to remove the plaque.
Treatment: Lipid-lowering drug. Surgery: Percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG).
in the blood. Normal levels are below 200 mg/dL for cholesterol and below 150 mg/dL for triglycerides. Treatment: Lipid-lowering drug.
to be hypertensive. Several blood pressure readings, not just one, are needed to make a diagnosis. Essential hypertension, the most common type of hypertension, is one in which the exact cause is not known. Secondary hypertension has a known cause, such as kidney disease.
Treatment: Lifestyle changes (decreased salt intake, increased exercise, weight loss) followed by an antihypertensive drug.
lying to a standing position and experiences lightheadedness. Treatment: Correct the underlying cause.
of a thrombus (blood clot). Treatment: Analgesic drug for pain, anti- inflammatory drug for inflammation. Antibiotic drug. Thrombolytic drug to dissolve a blood clot.
the vein. Laser or radiowaves to destroy the vein. These procedures redirect the blood into deeper veins.
infarct. Creatine kinase (CK) is found in all muscle cells, but a specific form of it (CK-MB) is only found in myocardial cells. The CK-MB level begins to rise 26 hours after a myocardial infarction. It is also known as creatine phosphokinase (CPK). Lactate dehydrogenase (LDH) is
found in many different cells, including the heart. The LDH level begins to rise 12 hours after a myocardial infarction. An elevated LDH can support the CK-MB results but cannot be the only basis for a diagnosis of myocardial infarction. Cardiac enzymes are measured every few hours for several days. This test is done in conjunction with troponin.
clot formation and a myocardial infarction. The high-sensitivity CRP test can detect a lower blood level of CRP and is used to predict a healthy persons risk of developing cardiovascular disease.
up to 10 days, so they can be used to diagnose a myocardial infarction many days after it occurred. Troponin levels are done in conjunction with cardiac enzyme levels.
This procedure is also referred to as a cardiac cath.
bicycle) are gradually increased while the patients heart rate, blood pressure, and ECG are monitored. The procedure is stopped if the patient complains of angina, palpitations, shortness of breath, or tiredness, or if
the ECG pattern becomes abnormal. The patients resting heart rate and maximum heart rate are compared to standards for other people of the same age and sex. Any abnormality in the ECG pattern is analyzed.
Electrodes (metal pieces in adhesive patches) are placed on the limbs (both arms and one leg) to send the electrical impulses of the heart to the ECG machine. These are the three limb leads (leads IIII). Electrodes placed on the chest are known as the precordial leads (V 1 V 6 ). A 12-lead
ECG records the electrical activity between different combinations of electrodes to give an electrical picture of the heart from 12 different angles. Samples of each of these 12 tracings are printed out and mounted on a backing for an electrocardiogram. A longer sample of
just a single lead tracing (usually lead II) is known as a rhythm strip.
to the heart. The catheters send out electrical impulses to stimulate the heart and try to cause an arrhythmia to pinpoint the ectopic site where the arrhythmia is coming from.
exercise stress test.
outline the coronary arteries and show narrowing or blockage. The x-ray is a coronary angiogram.
In rotational angiography, multiple x-rays are taken as the x-ray machine goes around the patient. This technique is particularly helpful in documenting tortuous blood vessels in three dimensions. Digital subtraction angiography (DSA) combines two x-ray images, one taken without radiopaque contrast dye and a second image taken after radiopaque contrast dye has been injected to outline the blood
vessel. A computer compares the two images and digitally subtracts or removes the soft tissues, bones, and muscles, leaving just the image of the arteries.
waves (ultrasound) that are bounced off the heart to create an image.
Two-dimensional echocardiography (2-D echo) creates a real-time
picture of the heart and its chambers and valves as it contracts and
in blue. Color flow duplex ultrasonography is the gold standard for evaluating tortuous varicose veins.
before any abnormality is evident on the image. Areas of no uptake indicate dead tissue from a previous myocardial infarction. Technetium- 99m is joined to a synthetic molecule (sestamibi). The combination of technetium-99m with sestamibi is the drug Cardiolite, so this test is also known as a Cardiolite stress test. In a thallium stress test,
thallium-201 is the radioactive tracer, or thallium-201 and technetium- 99m can be used. Myocardial perfusion PET scans are used to image the metabolism of the heart.
creates many individual images or slices (tomography) and compiles them into a three-dimensional image of the heart.
patients chest. The machine generates an electrical shock coordinated with the QRS complex of the patients heart to restore the heart to a normal rhythm. For a patient with ventricular fibrillation, the same machine is used (it is now called a defibrillator) to give a much stinger electrical shock. An automatic implantable cardioverter/defibrillator (AICD) is a small device that is implanted in a patient who is at high risk for developing a serious arrhythmia. The AICD is implanted under the skin of the chest. It has leads (wires) that go to the heart, sense its rhythm, and deliver an electrical shock, if needed. An automatic external defibrillator (AED) is a portable computerized device kept on emergency response vehicles and in public places like airports. It analyzes the patients heart rhythm and
delivers an electrical shock to stimulate the heart in cardiac arrest. An AED is designed to be used by nonmedical persons.
another, deeper vein, and the varicose vein is no longer distended.
The heart rate is measured by counting the pulse. The pulse can be felt in several different parts of the body. Pulse points include the carotid pulse in the neck, apical pulse on the anterior chest, axillary pulse in the armpit, brachial pulse at the inner elbow, radial pulse at the wrist, femoral pulse in the inguinal area (groin), popliteal pulse at the back of the knee, posterior tibial pulse at the back
of the lower leg, and the dorsalis pedis pulse on the dorsum of the foot. The radial pulse in the wrist is the most commonly used site. In an emergency, the carotid pulse is used because, if the patient is in shock, there is less blood flowing to the extremities. The apical pulse (at the apex of the heart) can be heard with a stethoscope
and is also used to evaluate the heart rhythm and heart sounds. The presence of peripheral vascular disease can be determined by comparing the strength of the pulse in the right leg to the same pulse on the left.
the patients blood is rerouted through a cannula in the femoral vein to a heart-lung machine. There, the blood is oxygenated, carbon dioxide and waste products are removed, and the blood is pumped back into the patients body through a cannula in the femoral artery. Cardiopulmonary bypass takes over the functions of the heart and lungs during the surgery.
made of plastic, metal, and other synthetic materials.
While awaiting a donor heart, the patient may have a left ventricular assist device (LVAD) temporarily implanted. This battery- or pneumatic- powered pump is placed in the abdomen and connected by tubes to the left ventricle and the aorta. In some patients, it becomes a permanent solution.
within the catheter is inflated. It compresses the atheromatous plaque and widens the lumen of the artery. Then the balloon is deflated and catheter is removed. Alternatively, an intravascular stainless steel mesh stent (unexpanded) can be inserted on the catheter. The stent is expanded, the catheter is removed, and the expanded stent remains in the artery.
occlusion uses heat to collapse and seal large varicose veins.
infarction, or an artificial heart valve heparin, warfarin (Coumadin), clopidogrel (Plavix)
sodium is excreted in the urine, it brings water and potassium with it because of osmotic pressure. This process is known as diuresis. This decreases the volume of
blood and is used to treat hypertension and congestive heart failure. Laypersons call these drugs water pills. furosemide (Lasix), hydrochlorothiazide (HCTZ)
generic drug names. atorvastatin (Lipitor), lovastatin (Mevacor), rosuvastatin (Crestor), simvastatin (Zocor)
dilate the arteries (to decrease the blood pressure) isosorbide (Isordil), nitroglycerin (Nitro-Dur)