Cardiac Assessment Overview

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Questions and Answers

Identify the primary function of the heart and outline the path of deoxygenated blood from tissues back to the heart.

The heart's primary function is to deliver oxygen to tissues. Deoxygenated blood returns from tissues to the heart via veins.

Describe the unique characteristic of the pulmonary artery and pulmonary vein in relation to oxygenated and deoxygenated blood flow.

The pulmonary artery carries deoxygenated blood from the heart to the lungs, while the pulmonary vein carries oxygenated blood from the lungs back to the heart. This is the opposite of typical arterial and venous blood flow.

Explain the difference in blood flow between the left and right sides of the heart.

Oxygenated blood is pumped out from the left side of the heart via arteries, while deoxygenated blood enters the right side of the heart through veins.

Describe the analogy used for the pulmonary system and explain its significance.

<p>The pulmonary system is likened to a tree, with its branching vessels resembling the structure of the lungs. This visualization helps understand the intricate network of blood vessels within the lungs.</p> Signup and view all the answers

Summarize the key difference between the arterial and venous systems.

<p>The arterial system consists of thick-walled muscular vessels carrying oxygenated blood away from the heart under high pressure, whereas the venous system carries deoxygenated blood back to the heart at lower pressure.</p> Signup and view all the answers

How does the structure of arteries relate to their function in the cardiovascular system?

<p>Arteries have thick muscular walls to withstand the high pressure of oxygenated blood being pumped from the heart.</p> Signup and view all the answers

Explain the importance of the physiological determinants in understanding the vascular system.

<p>Physiological determinants like cardiac output and blood pressure influence the efficiency of the vascular system, affecting blood flow and delivery of oxygen to tissues.</p> Signup and view all the answers

What are the implications of selected diagnostic studies related to the cardiac system?

<p>Diagnostic studies provide valuable insights into the structure and function of the heart, helping diagnose cardiac conditions, monitor treatment effectiveness, and make informed decisions about patient care.</p> Signup and view all the answers

Explain how afterload affects blood pressure and describe how it might relate to a patient's cardiovascular health.

<p>Afterload refers to the resistance the ventricles must overcome to eject blood. Higher afterload leads to increased blood pressure as the heart works harder to pump blood against increased resistance. This can put strain on the heart and contribute to cardiovascular disease, potentially leading to problems like hypertension or heart failure.</p> Signup and view all the answers

A patient with right-sided heart failure presents with swollen legs and fluid retention. Explain how right-sided heart failure causes these symptoms.

<p>Right-sided heart failure causes a backup of blood in the body, leading to congestion in the systemic circulation. This results in fluid buildup in the lower extremities, causing swelling (peripheral edema), and fluid retention in other parts of the body.</p> Signup and view all the answers

Explain how the SA node, AV node, Bundle of His, and Purkinje fibers work together to regulate the heartbeat. Describe the flow of the electrical impulse and its role in the cardiac cycle.

<p>The SA node, the heart's natural pacemaker, initiates the electrical impulse. This impulse travels to the AV node, which slightly delays it to ensure complete atrial contraction and ventricular filling. The delayed impulse then passes through the Bundle of His, which divides into right and left bundle branches. These branches continue down the interventricular septum to the Purkinje fibers, distributing the impulse throughout the ventricular tissue, triggering ventricular contraction. This coordinated sequence of impulses ensures a rhythmic, efficient heartbeat.</p> Signup and view all the answers

Describe the key factors that contribute to an individual's cardiac output and explain how this relates to blood pressure.

<p>Cardiac output, the amount of blood pumped by the heart per minute, is determined by heart rate and stroke volume. Increased heart rate or stroke volume leads to higher cardiac output, which in turn increases blood pressure.</p> Signup and view all the answers

Describe the relationship between the nervous system and the endocrine system in regulating heart rate and blood pressure. How do these systems affect the blood vessels?

<p>The nervous system and endocrine system collaborate to maintain appropriate heart rate and blood pressure. The nervous system sends rapid signals through nerves, influencing heart rate directly. Meanwhile, the endocrine system releases hormones like adrenaline or norepinephrine that can cause blood vessels to constrict, increasing blood pressure, or relax, decreasing blood pressure. This interplay between the nervous and endocrine systems ensures the body's vital circulatory functions can adapt to changing demands.</p> Signup and view all the answers

Explain the importance of monitoring potassium levels in a patient taking Lasix (furosemide) for fluid overload and why this might be necessary.

<p>Lasix, a diuretic, can deplete potassium levels, leading to hypokalemia. Monitoring potassium levels is crucial to prevent complications such as arrhythmias and muscle weakness. Potassium supplements may be necessary to maintain electrolyte balance.</p> Signup and view all the answers

Explain the differences between systole and diastole in terms of heart function and blood pressure. How does Starling's Law and cardiac output relate to systole?

<p>Systole is the contraction phase of the cardiac cycle, where the heart muscle squeezes, ejecting blood into the arteries. Blood pressure rises during this phase as the heart exerts force on the blood. Diastole is the relaxation phase, where the heart chambers fill with blood, and blood pressure decreases. Starling's Law relates to systole by stating that the heart's force of contraction is proportional to its initial stretch. Increased venous return during diastole stretches the heart muscle, leading to a stronger contraction during systole and higher cardiac output, the volume of blood pumped per minute.</p> Signup and view all the answers

Compare and contrast the symptoms of left-sided and right-sided heart failure. Explain why these differences occur.

<p>Left-sided heart failure leads to pulmonary congestion, causing shortness of breath and potential respiratory distress, while right-sided heart failure causes peripheral edema and fluid retention due to blood back up in the body. The differences arise because the left side pumps blood to the lungs, while the right side pumps blood to the body.</p> Signup and view all the answers

Explain how blood pressure reflects the pressure generated during the cardiac cycle and describe what factors contribute to changes in blood pressure.

<p>Blood pressure is the force exerted by blood against the vessel walls, a direct result of the pressure fluctuations during the cardiac cycle. Systole, the contraction phase, generates higher pressure as the heart forcefully pumps blood out. Diastole, the relaxation phase, results in lower pressure as the heart refills. Various factors influence blood pressure, including the force and volume of blood ejected by the heart (cardiac output), the resistance to blood flow in the vessels (peripheral vascular resistance), and the overall volume of blood in the circulatory system (blood volume).</p> Signup and view all the answers

A patient presents with chest pain, shortness of breath, and diaphoresis. What condition do these symptoms suggest? Explain why this condition is a serious concern.

<p>These symptoms suggest a myocardial infarction (MI) or heart attack. This is a serious concern because it indicates a blockage in the coronary arteries, depriving the heart muscle of oxygen and potentially leading to permanent damage or even death if not treated promptly.</p> Signup and view all the answers

Why is it crucial to obtain a detailed family history when assessing a patient's cardiovascular health? Explain your reasoning.

<p>A family history of cardiovascular disease, diabetes, kidney disease, or hypertension can indicate a genetic predisposition to these conditions, increasing the patient's risk. Understanding the family history helps identify potential risk factors and inform preventive strategies and early intervention if needed.</p> Signup and view all the answers

Describe the specific roles of the excitability, automaticity, and conductivity properties of cardiac cells in the functioning of the heart. How do these properties contribute to the synchronized and coordinated muscle contractions essential for effective blood circulation?

<p>Excitability allows cardiac cells to respond to stimuli and trigger electrical impulses. Automaticity grants the heart the ability to generate its own rhythm, independent of external stimulation, primarily through the SA node. Conductivity allows the electrical impulses to propagate rapidly throughout the heart, facilitating coordinated contraction of cardiac muscle cells. These properties work together to ensure a synchronized, rhythmic sequence of contractions throughout the heart, essential for efficient blood pumping and circulation.</p> Signup and view all the answers

Explain the significance of the valves in the venous system, highlighting their role in blood flow and medical applications.

<p>Valves in the venous system are crucial for directing blood flow upwards towards the heart, countering the effects of gravity. These valves prevent backflow, ensuring efficient blood return. The presence of valves also allows for intravenous (IV) infusions, where medications can be introduced directly into the bloodstream, bypassing the digestive system and reaching the circulatory system quickly.</p> Signup and view all the answers

How do the intermodal pathways facilitate the coordinated contraction of the atria? Why is this crucial for optimal blood flow?

<p>Intermodal pathways act as a network of specialized conducting fibers that transmit electrical impulses from the SA node across the atria. This synchronized spread of the impulse ensures that all atrial muscle cells contract simultaneously, efficiently propelling blood from the atria into the ventricles. This coordinated atrial contraction is crucial for optimal blood flow to the ventricles, maximizing filling before ventricular contraction and improving overall cardiac output.</p> Signup and view all the answers

Explain the relationship between preload and stroke volume and how this ultimately affects cardiac output and blood pressure.

<p>Preload, the amount of blood in the ventricles at the end of diastole, directly influences stroke volume. Higher preload leads to increased stretch of the heart muscle, resulting in a stronger contraction and therefore greater stroke volume. This increased stroke volume directly contributes to higher cardiac output and, subsequently, higher blood pressure.</p> Signup and view all the answers

Explain why the delay introduced by the AV node is essential for proper heart function, providing a specific example to illustrate its importance.

<p>The delay introduced by the AV node is vital for proper heart function because it allows time for complete atrial contraction and filling of the ventricles before ventricular contraction. This ensures that the ventricles receive the maximum possible volume of blood before being pumped out to the body. For example, if the impulse passed directly from the SA node to the ventricles without this delay, the ventricles might contract too soon, before they were fully filled, resulting in a weakened heartbeat and reduced blood flow.</p> Signup and view all the answers

Describe the path of blood flow through the heart, beginning with its entry into the right atrium and ending with its expulsion from the left ventricle. Identify the key structures involved in this process and their functions.

<p>Deoxygenated blood enters the heart through the superior vena cava, emptying into the right atrium. From there, it flows through the tricuspid valve into the right ventricle. The right ventricle pumps the blood through the pulmonary valve into the pulmonary arteries, where it travels to the lungs to become oxygenated. Oxygenated blood then returns to the heart through the pulmonary veins, entering the left atrium. It passes through the mitral valve into the left ventricle. Finally, the left ventricle pumps oxygenated blood through the aortic valve and into the aorta, delivering it to the rest of the body.</p> Signup and view all the answers

Explain the significance of the pericardium in the functioning of the heart. How does it contribute to the heart's efficient pumping action?

<p>The pericardium is a protective sac surrounding the heart, containing a fluid layer that reduces friction between the heart and surrounding tissues. This lubrication allows the heart to contract and relax smoothly without excessive stretching or strain, facilitating efficient pumping action. The pericardium ensures a smooth and fluid movement of the heart as it pumps blood throughout the body.</p> Signup and view all the answers

Compare and contrast the role of the AV valves and the semilunar valves in the flow of blood during the cardiac cycle, highlighting their opening and closing movements.

<p>The AV valves (tricuspid and mitral) separate the atria from the ventricles, allowing blood to flow from the atria into the ventricles during diastole. These valves close during ventricular systole to prevent backflow of blood into the atria. The semilunar valves (aortic and pulmonary) separate the ventricles from the aorta and pulmonary arteries, respectively. They open during systole to allow blood to be ejected from the ventricles. They close during diastole to prevent backflow of blood from the aorta and pulmonary arteries into the ventricles. Both types of valves regulate blood flow in a unidirectional manner, ensuring efficient and effective blood circulation.</p> Signup and view all the answers

Compare and contrast the functions of arteries and veins, emphasizing their roles in oxygen and nutrient transport. How does the structure of these vessels reflect their specific functions?

<p>Arteries carry oxygenated blood away from the heart to the rest of the body, while veins carry deoxygenated blood back to the heart. Arteries have thicker walls with more elastic fibers to withstand the high pressure of blood pumped from the heart, while veins have thinner walls with valves to assist in the return of blood against gravity. These structural differences reflect their distinct functions in oxygen and nutrient distribution.</p> Signup and view all the answers

Explain the importance of the capillary beds in the circulatory system. Describe the processes that occur within these networks and their contribution to overall bodily function.

<p>Capillary beds are the sites of exchange between the circulatory system and the surrounding tissues. Here, oxygen and nutrients from the blood diffuse into cells, while carbon dioxide and other waste products from cells diffuse into the blood stream. This vital exchange process is crucial for maintaining cellular function, providing essential resources and removing metabolic byproducts, supporting overall body function.</p> Signup and view all the answers

Explain the function of the heart valves, focusing on their role in preventing backflow of blood. Discuss the specific function of the tricuspid and mitral valves and their placement within the heart.

<p>Heart valves act as one-way gates, preventing backflow of blood and ensuring its unidirectional movement through the heart. The tricuspid valve, located between the right atrium and ventricle, prevents backflow of blood from the ventricle into the atrium during ventricular contraction. Similarly, the mitral (bicuspid) valve, located between the left atrium and ventricle, prevents blood from flowing back into the atrium when the left ventricle contracts. These valves ensure efficient blood movement through the chambers of the heart.</p> Signup and view all the answers

Discuss the significance of the pulmonary arteries in the circulatory system. Why is it important to note that they are arteries, not veins, despite carrying deoxygenated blood?

<p>Pulmonary arteries, despite carrying deoxygenated blood, are classified as arteries because they carry blood away from the heart. Specifically, they carry deoxygenated blood from the right ventricle to the lungs for oxygenation. It is important to note their arterial nature because it reflects their function as a vessel that carries blood away from the heart, a defining characteristic of arteries.</p> Signup and view all the answers

Describe the process of waste removal from the body, starting with its origin in cells and ending with its elimination. How does the circulatory system play a crucial role in this process?

<p>Waste products generated by cellular metabolism are transported by the bloodstream to various organs for processing. The liver plays a key role in processing and detoxifying waste products. Finally, these processed wastes are excreted from the body through various routes, such as urination and defecation. The circulatory system is essential for transporting waste products from their origins in cells to the organs responsible for their processing and elimination.</p> Signup and view all the answers

A patient presents with chest pain and elevated troponin levels. Troponin levels continue to rise. Explain the most likely underlying cause of the elevated troponin levels and the significance of its continuous rise.

<p>The patient is likely experiencing an ongoing heart attack (myocardial infarction). The continued rise in troponin levels indicates that the heart muscle is still being damaged, highlighting the ongoing nature of the event.</p> Signup and view all the answers

Why is myoglobin, a cardiac marker, not considered specific to the heart and what are the potential reasons for its elevation besides a heart attack?

<p>Myoglobin is released not only from the heart muscle but also from skeletal muscle, making it less specific for heart damage. Conditions like strenuous exercise or muscle injury can also elevate myoglobin levels.</p> Signup and view all the answers

A patient presents with symptoms of heart failure, including shortness of breath and fatigue. What cardiac marker is most likely to be elevated in this case and what does the elevation indicate?

<p>Brain natriuretic peptide (BNP) is likely to be elevated in this scenario. Elevated BNP levels indicate heart strain and overstretching of the ventricular tissue, which is a hallmark of congestive heart failure (CHF).</p> Signup and view all the answers

What are the advantages of using a transesophageal echocardiogram (TEE) over a conventional echocardiogram (ECHO) for cardiac evaluation? When might a TEE be preferred?

<p>TEE provides clearer images of the heart structures because the ultrasound probe is inserted directly into the esophagus. TEE is preferred for obtaining detailed views of the heart, especially when other imaging methods are insufficient, or when identifying specific heart conditions.</p> Signup and view all the answers

Describe the purpose and limitations of a Chest X-ray in evaluating cardiac health. When might this imaging be indicated in a cardiac assessment?

<p>Chest X-ray assesses heart size and shape. It can't directly diagnose heart disease but can identify cardiac enlargement or pulmonary congestion. It's often used to assess for these findings in conjunction with other cardiac evaluations.</p> Signup and view all the answers

Compare and contrast the two methods used for cardiac stress testing. Briefly explain the advantages and disadvantages of each method.

<p>Treadmill test involves physical exertion while monitoring ECG and vital signs, making it readily available but unsuitable for patients unable to exercise. Pharmacologic stress test uses medication to induce heart stress, beneficial for those who can't exercise but requires injection and may involve more complications.</p> Signup and view all the answers

Explain the difference in approach and potential applications of a right heart catheterization compared to a left heart catheterization.

<p>Right heart catheterization involves inserting a catheter into a vein to measure pressures and blood flow in the right side of the heart, often used for evaluating heart failure or pulmonary hypertension. Left heart catheterization uses an arterial approach to evaluate the left side of the heart, particularly the coronary arteries, and is frequently used for diagnosing coronary artery disease or heart valve disease.</p> Signup and view all the answers

A patient presents with a troponin level of 0.06 ng/mL and a myoglobin level of 120 ng/mL. What are the possible interpretations of these results? Explain your reasoning.

<p>The elevated myoglobin level along with the slightly elevated troponin level suggest potential muscle injury. The elevated troponin value could be due to a relatively minor or recent heart event, or it could be due to other factors, such as strenuous exercise or skeletal muscle injury. The myoglobin level is suggestive of skeletal muscle damage, possibly due to exertion or injury. It is important to consider the patient's clinical presentation and history to determine the most likely cause.</p> Signup and view all the answers

Explain why a patient experiencing chest pain should seek medical attention immediately, even if their CKMB levels normalize within 36 hours.

<p>Even if CKMB levels return to normal, it does not necessarily mean the patient has fully recovered from a heart attack. Troponin levels, which remain elevated for a longer period, can still provide a more accurate indication of cardiac damage. Therefore, seeking medical attention immediately ensures timely and accurate diagnosis and management of potential heart attack complications.</p> Signup and view all the answers

Describe the role of HDL in preventing cardiovascular disease and how it differs from LDL.

<p>HDL, known as 'good cholesterol,' removes excess cholesterol from the bloodstream and transports it to the liver for excretion. This process helps prevent plaque buildup in arteries. Conversely, LDL, or 'bad cholesterol,' primarily transports cholesterol into cells but can also deposit it on arterial walls, contributing to atherosclerosis.</p> Signup and view all the answers

What are the potential consequences of neglecting elevated cholesterol levels? Explain the relationship between cholesterol and atherosclerosis.

<p>Neglecting elevated cholesterol levels can lead to atherosclerosis, a condition where plaque accumulates in the arteries. This buildup narrows the arteries, restricting blood flow. It increases the risk of heart attack, stroke, and pulmonary embolism. As cholesterol is not water-soluble, it binds with proteins to form lipoproteins, including LDL. LDL deposition in the arteries contributes to atherosclerosis.</p> Signup and view all the answers

Explain why troponin levels are considered the gold standard for detecting heart attacks compared to CKMB.

<p>Troponin levels remain elevated for up to 10 days after a heart attack, offering a longer window for detection. CKMB levels, while specific to cardiac tissue, only remain elevated for 36 hours. This makes troponin tests more reliable, especially when patients seek medical attention after a delayed onset of symptoms.</p> Signup and view all the answers

What does a lipid panel test measure, and how is the information used for patient management?

<p>A lipid panel measures total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. These values provide insight into a patient's cardiovascular risk. Elevated cholesterol levels, particularly LDL, indicate an increased risk of atherosclerosis and related cardiovascular complications. Results guide medical professionals in recommending lifestyle modifications, medications, or other relevant interventions.</p> Signup and view all the answers

How are troponin tests used to monitor the progression of a heart attack?

<p>Troponin tests are taken every 3 to 6 hours to monitor the progression of a heart attack. Increasing troponin levels indicate that the heart attack is worsening. Decreasing troponin levels suggest that the damage is stabilizing, and the heart is recovering. These trends help clinicians adjust treatment strategies effectively.</p> Signup and view all the answers

Explain why cholesterol is essential for the body even though elevated levels can be detrimental.

<p>Cholesterol is essential for synthesizing hormones, forming cell walls, and other vital biological processes. However, excessive cholesterol accumulation, particularly LDL, contributes to atherosclerosis, a serious cardiovascular condition. Maintaining healthy cholesterol levels through diet, lifestyle modifications, or medications is crucial for overall health.</p> Signup and view all the answers

Describe three ways a person can reduce their risk of developing heart disease.

<p>Maintaining a healthy weight, engaging in regular physical activity, consuming a balanced diet that includes fruits, vegetables, and whole grains, and managing stress through relaxation techniques or other healthy practices are some ways to reduce the risk of heart disease. Additionally, managing high blood pressure and cholesterol levels, if necessary, is critical.</p> Signup and view all the answers

Flashcards

Cardiac Assessment

The evaluation of the heart's function and structure.

Cardiac Output

The volume of blood the heart pumps per minute.

Pulmonary Artery

Carries deoxygenated blood from the heart to the lungs.

Pulmonary Vein

Carries oxygenated blood from the lungs to the heart.

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Arterial System

System of blood vessels that carry oxygenated blood away from the heart.

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Venous System

System of blood vessels that return deoxygenated blood to the heart.

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Vascular System

Comprises all the blood vessels in the body.

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Oxygen Delivery

The primary function of the heart delivering oxygen to tissues.

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Capillary Beds

Sites where nutrient and oxygen exchange occurs with waste removal.

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Right Atrium

Upper chamber that receives deoxygenated blood from the body.

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Pulmonary Arteries

Arteries that carry deoxygenated blood from the heart to the lungs.

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Mitral Valve

Valve between the left atrium and ventricle, allowing blood flow into the ventricle.

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Tricuspid Valve

Valve between the right atrium and ventricle, preventing backward blood flow.

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Pericardium

The membrane surrounding the heart, containing lubricating fluid.

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Heart Valves

Valves that prevent backflow of blood and ensure one-way circulation.

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Heart Function

The heart moves blood through the body, delivering oxygen and nutrients.

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Heart Rate

The speed at which the heart beats, controlling rhythm and blood flow.

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Cardiac Cycle

The sequence of events for muscular contractions to pump blood.

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Diastole

The phase when the heart relaxes and chambers fill with blood.

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Systole

The phase when the heart contracts to push blood out to the body.

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Cardiac Conduction

The system of electrical impulses that control heartbeats.

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SA Node

The heart's natural pacemaker that initiates impulses.

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Blood Pressure

The force exerted by blood flow against vessel walls during the cardiac cycle.

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Blood Pressure Factors

Factors include cardiac output, afterload, preload, and vessel resistance.

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Stroke Volume

The amount of blood ejected from the heart with each contraction.

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Preload

The amount of blood in the ventricles at the end of diastole, affecting stroke volume.

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Afterload

The resistance the ventricles must overcome to eject blood during systole.

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Left Sided Heart Failure

Blood backs up into the lungs, causing congestion and shortness of breath.

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Right Sided Heart Failure

Blood backs up into the body, causing peripheral edema and fluid retention.

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Troponin Levels

Markers that rise during a heart attack, indicating myocardial damage.

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Myoglobin

A cardiac marker not specific to the heart, increases with muscle damage.

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Brain Natriuretic Peptide (BNP)

A marker released from overstretched ventricles, indicating heart failure.

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Normal Troponin Value

A normal lab value for troponin is < 0.04 ng/mL.

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Electrocardiogram (ECG)

A test measuring the heart’s electrical activity, used for cardiac assessment.

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Echocardiogram (ECHO)

An ultrasound to assess heart function and measure ejection fraction.

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Cardiac Stress Test

Evaluates heart function under stress, either via treadmill or medication.

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Cardiac Catheterization

An invasive procedure assessing heart function and coronary arteries.

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Total Cholesterol

The overall cholesterol level in the blood, ideal is less than 200 mg/dL.

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LDL

Low-Density Lipoprotein, known as 'bad cholesterol', should be less than 100 mg/dL.

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HDL

High-Density Lipoprotein, known as 'good cholesterol', ideal levels are between 40-60 mg/dL.

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Triglycerides

A type of fat in the blood; normal levels should be less than 150 mg/dL.

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Lipid Panel

A blood test measuring total cholesterol, LDL, HDL, and triglycerides.

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Creatine Kinase (CK)

A marker of cellular injury, not specific to heart damage.

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CKMB

A specific marker released during myocardial damage, elevates within 3 hours.

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Troponins

Proteins released during a heart attack, gold standard for heart damage detection.

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Study Notes

Cardiac Assessment

  • Learning Outcomes: Describe physiological determinants of vascular system components relating to cardiac output. Explain components of cardiac examination history and physical, and implications of diagnostic tests related to cardiac function.
  • Heart Function: The primary function of the heart is delivering oxygen to tissues. Deoxygenated blood returns to the heart via veins. Only the pulmonary artery and vein function in the opposite direction compared to other arteries and veins, meaning oxygen-poor blood is pumped out from the heart via the pulmonary artery and oxygen-rich blood is pumped back to the heart via the pulmonary vein. Arteries carry oxygenated blood from the heart to tissues, while veins carry deoxygenated blood back to the heart.
  • Pulmonary System: The pulmonary system, analogous to a branching tree, resembles lung structures. The pulmonary artery and vein are the only reversed systems in the vascular network. Blood is oxygenated within the lungs before returning to the heart via pulmonary veins.
  • Arterial vs. Venous System: Arteries are high-pressure, thick-walled vessels carrying oxygenated blood from the heart. Veins, conversely, are low-pressure vessels containing valves that assist blood return to the heart, making them ideal for intravenous infusions.
  • Capillary Beds: Nutrients and oxygen exchange, and cellular waste removal occurs within capillary beds. Blood vessels can constrict or dilate based on the body's metabolic needs.
  • Heart Anatomy: The heart includes the atria (upper chambers) and ventricles (lower chambers). Blood enters the right atrium, then right ventricle, then pulmonary arteries to the lungs. Reoxygenated blood returns through pulmonary veins to the left atrium, then to the left ventricle. The heart has multiple valves (e.g., tricuspid, mitral, pulmonary, aortic) that regulate blood flow.
  • Heart Valves: Tricuspid and mitral valves are located between atria and ventricles. Semilunar valves are located between ventricles and arteries (pulmonary and aortic). These valves function to prevent backflow during the cardiac cycle.
  • Coronary Arteries: The coronary arteries branch off the aorta, supplying blood to the heart muscle itself.
  • Heart Conduction System: The heart's electrical conduction system (e.g., SA node, AV node, Bundle of His) regulates the heart's rhythm. This system ensures coordinated contraction of the heart chambers.
  • Cardiac Cycle and Blood Pressure: The cardiac cycle involves the rhythmic pumping action of the heart to circulate blood. The cycle consists of diastole (relaxation and filling) and systole (contraction and ejection). Blood pressure is the force exerted by blood against vessel walls, influenced by cardiac output and peripheral vascular resistance.
  • Major Risk Factors: A thorough medical history of cardiovascular risk factors is critical. These may include family history of heart conditions, diabetes, hypertension, hyperlipidemia, and current health.
  • Cardiac Markers: Cardiac markers (e.g., CKMB, troponins, myoglobin, BNP) are substances released into the blood in response to heart damage, enabling the diagnosis of myocardial infarction (MI).

Diagnostic Studies and Cardiac Markers

  • Creatine Kinase (CK): A general marker of cellular injury, released from muscle tissue when damage occurs. It increases within 3 hours and lasts for 36 hours.
  • CK-MB (Creatine Kinase-muscle): A more specific marker for myocardial damage, increasing within 3 hours and peakinng within 12-24 hours.
  • Troponins: The most reliable markers for myocardial infarction, as levels elevate within 4 hours of an MI and remain high for up to 10 days.
  • Myoglobin: Released by muscle tissue, and it's present in the bloodstream following muscle injury (including the skeletal muscles).
  • Brain Natriuretic Peptide (BNP): Key marker for heart failure (and cardiomyopathy). Levels elevate in response to stress in the ventricles, and remain high.

Cardiac Imaging and Procedures

  • Chest X-ray: Can detect cardiac enlargement, pulmonary edema, and other relevant conditions.
  • Echocardiogram (ECHO): Uses ultrasound to evaluate heart structural integrity, function, and to measure ejection fraction.
  • Transesophageal Echocardiogram (TEE): Provides a more detailed assessment of heart structures because the ultrasound probe is inserted into the esophagus.
  • Cardiac Stress Testing (Treadmill or Pharmacologic): Evaluates the heart's ability to pump blood during exertion, useful in monitoring stress and cardiovascular function.
  • Cardiac Catheterization: An invasive procedure to evaluate heart function and coronary arteries. Involves inserting a catheter into the heart to measure blood pressure, and oxygen levels and to visualize heart structures.

Physiological Changes with Aging

  • Cardiovascular Changes: As people age, changes occur to the cardiovascular system, including left ventricular atrophy, decreased aortic elasticity, and increased heart valve rigidity.
  • Hypertension: Age-related changes like stiffening of arteries and plaque buildup contribute to increased blood pressure in older adults

Other Information

  • Atrial Fibrillation (Afib): An irregular heart rhythm that often results in uncoordinated contractions of the atria. It is often caused by electrical misfiring in the heart.
  • Stroke Types: Ischemic strokes are caused by a clot or plaque buildup, and hemorrhagic strokes result from ruptured blood vessels.

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