Cardiac Presentation
Cardiac Presentation
MELISSA DEAN
Objectives
Basic Anatomy
Functions
Heart
Chambers
Valves
Blood Flow
Conduction
Circulatory
Arteries
Veins
Flow through the body
Cardiac Assessment
Auscultation
S1, S2
Adventitious Heart Sounds
Pulses
Cap refill
Disease Processes
Circulatory Functions
Delivery system
Oxygen
Nutrients
Hormones
Blood Cells
RBCs
WBCs
Platelets
Removal system
Waste products
Heart
Basic anatomy
Heart
Exterior anatomy
RCA
Coronary veins
Heart
Internal anatomy
Heart
Chambers
Right atrium
Right ventricle
Left atrium
Left ventricle
Valves
Tricuspid
Mitral
Pulmonic
Aortic
Heart Chambers
Cardiac conduction
Specialized cells
Send messages that cause
contraction
SA node - sinoatrial
AV node - atrioventricular
Bundle of His
Bundle branches
Purkinje fibers
Cardiac conduction
SA node
Pacemakers
SA and AV nodes
Sympathetic/parasympathet
ic
Regulates heart rate
Impulse origin
Regulates
Both atria left and right
AV node
AV node
Regulates
Both ventricles left and right
Septum
Delays conduction
Boosts ventricular filling
Cardiac conduction
Bundle of His
Muscle fibers
Also called AV bundle
Bundle branches
Left
Right
Purkinje fibers
Cardiac conduction
Heart Conduction
Vascular
There and back again
Vascular
Arteries
Veins
Deoxygenated blood
Pulmonary artery
Pulmonary veins
Muscular walls
High pressure
Low pressure
No valves
Valves
Anatomy
Cardiac
Assessment
Murmurs
Heart Sounds
S1 Closure of valves
Mitral
Tricuspid
S2 Closure of valves
Aortic
Pulmonic
S4 Arterial gallop
HTN
Anemia
Stenosis
Aortic
Pulmonary
Pulmonary emboli
Heart Sounds
Diastolic
Aortic regurgitation
Pulmonic regurgitation
Between S2 and S1
Grades
I- VI
I Very faint
II Faint but recognizable
III Loud but moderate
IV Loud with thrill
V Loud, thrill, stethoscope
partially touching
VI Audible without
stethoscope
Heart Sounds
Stethoscope
Placement
Rate
Absence
Cap refill
Brisk, sluggish
Color
Pink and healthy, cyanotic,
dusky
Cardiac tests
Blood work
X ray
Stress test
CT
SPECT
MRI
Elecrophysiology studies
Electrocardiogram
Angiography
Echocardiogram
Dopplers
Vitals signs
ProBNP
Cholesterol
CBC
CMP
RFP
Clotting studies
CRP
Vitals signs
Simplest test
Can reveal a lot
Electrocardiogram
Basic 5 lead basic info
12 lead
Better view of all parts of the
heart
Can tell us
Dysrhythmias
Ischemia
Cardiac enlargement
Echocardiogram
Uses Doppler
Views the heart
TEE
Dopplers
Views structure
Veins
Arteries
Angiography
Evaluation
Interventions
Stent placement
Clot removal
Minimally invasive surgeries
Cardiovascular
DISEASE
Disease
MI myocardial infarction
CAD coronary heart
disease
CHF congestive heart
failure
Atherosclerosis
PVD peripheral artery
disease
DVT Deep vein thrombosis
Dysrhythmias
Aneurysm
Raynauds disease
Pericardial disease
Buergers disease
Hypertrophy
MI myocardial infarction
Blood flow
Damage
Symptoms
Chest pain
Radiated pain
S.O.B.
Nausea
Diaphoresis
Syncope
MI interventions
Treatment varies
Oxygen
Pain relief
Medications
Tests
12 lead
Lab work
Chest X-ray
Thrombolytics
Surgical
Goal reperfusion
MI
STEMI or NSTEMI?
STEMI
C
Obtain a 12 lead EKG
Heart Failure
Left sided CHF
EF - <40%
Ventricular remodeling
Lungs
S.O.B.
Heart Failure
Reduce symptoms
Tests
Lifestyle changes
Quit smoking
Monitor weight
Medications
Surgery
B
Inquire about medication
compliance
Types
Functional
Raynauds disease
Treatment
Lifestyle changes
Medications
Manage DM if applicable
Surgery
C
Is the leg pain relieved by rest?
The Lungs
October 27th