Cardiovascular Emergencies & Heart Failure

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Questions and Answers

What is the purpose of the pulmonary circulation?

To carry deoxygenated blood to the lungs. (correct)

To carry oxygenated blood to the body.

To carry deoxygenated blood to the body.

To carry oxygenated blood to the lungs.

What is the main difference between systemic and pulmonary circulation?

Systemic circulation carries oxygenated blood, while pulmonary circulation carries deoxygenated blood.

Systemic circulation is low pressure, while pulmonary circulation is high pressure.

Systemic circulation carries deoxygenated blood, while pulmonary circulation carries oxygenated blood.

Systemic circulation is high pressure, while pulmonary circulation is low pressure. (correct)

Where does deoxygenated blood from the body first enter the heart?

Left atrium

Right atrium (correct)

Right ventricle

Left ventricle

What valve separates the right atrium from the right ventricle?

Tricuspid Valve (C) Signup and view all the answers

Which of the following carries deoxygenated blood to the lungs?

Pulmonary Artery (A) Signup and view all the answers

What valve regulates blood flow from the left ventricle to the aorta?

Aortic Valve (A) Signup and view all the answers

Which of these blood vessels are involved in the exchange of oxygen and nutrients with body tissues?

Capillaries (A) Signup and view all the answers

Where does deoxygenated blood from the lower body return to the heart?

Inferior Vena Cava (A) Signup and view all the answers

Which coronary artery supplies blood to the inferior portion of the left ventricle?

Right Coronary Artery (RCA) (A) Signup and view all the answers

What happens to coronary blood flow during diastole?

The aortic valve closes, allowing the coronary arteries to fill with blood. (B) Signup and view all the answers

What is the term often used to describe a blockage in the Left Anterior Descending Artery (LAD)?

Widow-maker (A) Signup and view all the answers

What is the primary function of the coronary arteries?

To supply oxygen and nutrients to the heart muscle. (A) Signup and view all the answers

What cardiovascular condition can lead to compromised coronary perfusion?

Coronary Artery Disease (C) Signup and view all the answers

What is the physiological response of the coronary arteries to increased myocardial oxygen demand?

The arteries dilate to increase blood flow. (D) Signup and view all the answers

What is the term for a lack of oxygen to the heart muscle?

Ischemia (D) Signup and view all the answers

Which of the following is NOT a direct branch of the Left Coronary Artery (LCA)?

Right Coronary Artery (RCA) (C) Signup and view all the answers

What is the primary function of the pericardium?

To protect the heart and act as a lubricant during contraction and relaxation. (D) Signup and view all the answers

Which of the following is NOT a component of the heart's blood flow system?

Aortic Valve (A) Signup and view all the answers

Which chamber of the heart receives deoxygenated blood from the body?

Right Atrium (C) Signup and view all the answers

Which valve prevents the backflow of blood from the right ventricle to the right atrium?

Tricuspid Valve (B) Signup and view all the answers

What is the function of the chordae tendineae associated with the heart valves?

To prevent the backflow of blood during ventricular contraction. (D) Signup and view all the answers

What is the name of the period when the ventricles are contracting and pushing blood out of the heart?

Systole (D) Signup and view all the answers

Which of the following is the correct sequence of blood flow through the heart?

Right Atrium - Right Ventricle - Pulmonary Artery - Left Atrium - Left Ventricle - Aorta (A) Signup and view all the answers

The heart's ability to contract and relax is primarily due to which layer?

Myocardium (B) Signup and view all the answers

Study Notes

Cardiovascular Emergencies & Acute MI & Heart Failure

Images of ECG are shown, indicating cardiovascular emergencies and acute MI, and heart failure.
The study of cardiovascular emergencies is presented.

Cardiovascular System

The cardiovascular system has the purpose of delivering oxygen, nutrients, hormones, and other protective components to the body cells.
Pulmonary circulation is low pressure, which allows slow movement through the lungs for improved gas exchange.
Systemic circulation is high pressure, which moves blood against gravity to allow for blood return to the heart from the body tissues.
Deoxygenated blood returns to the heart from the body through the superior and inferior vena cava, then enters the right atrium.
The deoxygenated blood moves through the tricuspid valve to the right ventricle.
The right ventricle pumps deoxygenated blood, through the pulmonary artery to the lungs.
The oxygenated blood in the lungs is transported through pulmonary veins to the left atrium.
Through the mitral valve, the oxygenated blood goes to the left ventricle.
The oxygenated blood is pumped through the aortic valve into the aorta, delivering oxygenated blood to the body.
Deoxygenated blood returns to the heart via superior and inferior vena cava.
A network of arteries and arterioles deliver the oxygenated blood to the organs and tissues.
Waste products are collected from the tissues by the venules and veins.
The blood returns to the heart as deoxygenated blood through the vena cava.

The Heart

The layers of the heart are the pericardium, epicardium, myocardium, and endocardium.
The pericardium is an outer sac with pericardial fluid that minimizes friction.
The epicardium is an outer layer covering all vessels and folds to form the pericardium.
The myocardium is the muscular layer that contracts.
The endocardium is the inner layer lining the interior heart and valves.
Systolic is the ventricular contraction.
70% of blood volume is the stroke volume (SV).
Diastolic is the ventricular relaxation.
The ventricles accept blood from the atria.

The Heart: Chambers & Valves

The heart has four chambers: Right Atrium, Right Ventricle, Left Atrium, and Left Ventricle.
The heart has four valves: Tricuspid, Pulmonary, Mitral (Bicuspid), and Aortic.
Each valve has a unique function, to allow blood to flow in one direction.

The Heart: Blood Flow

The heart has its own network of vessels called coronary arteries.
The main coronary arteries are the left coronary artery and the right coronary artery.
The left coronary artery branches into the left anterior descending artery and the left circumflex artery.
The LAD artery supplies blood to the anterior part of the left ventricle and a portion of the interventricular septum.
The right coronary artery supplies blood to the right atrium, right ventricle, and the inferior part of the left ventricle.
During diastole, the resting phase of the cardiac cycle, the coronary arteries fill with oxygenated blood.

Coronary Perfusion Process

During diastole, the coronary arteries receive blood flow.
As the heart relaxes, the aortic valve closes, and the coronary arteries fill with oxygenated blood.
Oxygenated blood, rich in nutrients, is delivered to the myocardium through small branches of the coronary arteries.

Coronary Artery Disease (CAD)

Coronary perfusion can be compromised in conditions like CAD, where the coronary arteries may become narrowed or blocked by atherosclerotic plaques.
Reduced blood flow leads to ischemia (lack of oxygen) and potential myocardial infarction (heart attack).

Cardiovascular System Nursing Assessment

Inspection (for pallor or cyanosis, visible PMI), palpation (warm skin, capillary refill <2 seconds), palpate the abdominal and carotid pulses for symmetry).
Auscultation (for S1 and S2 heart sounds, regular rate, rhythm, and absence of murmurs).
Important subjective assessment questions include chest pain, discomfort, palpitations, shortness of breath.
History of edema, symptom onset, aggravating/relieving factors Assess for other objective and subjective data as needed

Pericarditis

Inflammation of the pericardium (sac surrounding the heart)
Common Symptoms: chest tightness, increased pain with lying flat, sharp/stabbing pain that's relieved by sitting/leaning forward, muffled heart sounds.

Cardiac Tamponade

Fluid accumulates in the pericardial sac, causing pressure on the heart and unable to completely fill.
Symptoms: dyspnea, dizziness, chest tightness, increasing restlessness, pulsus paradoxus (>10mmHg drop in BP during inspiration).
Nursing care includes monitoring for hypotension, tachycardia, muffled heart sounds and jugular vein distension.

Cardiac Biomarkers

The cardiac biomarkers include troponin, CK-MB, and BNP.
Troponin is a contractile protein released from the cardiac muscle during mismatch between oxygen demand and supply (ischemia).
CK-MB is a cardiac enzyme that increases 3-6 hours post-injury and peaks at 12-24 hours.
BNP is a hormone released by the ventricles. Measurement of these markers can help diagnose heart conditions, especially MI.

Myocardial Infarction

Prolonged ischemia leads to irreversible damage (cell death).
Blood flow obstruction.
Myocardial oxygen demand exceeds supply.
Risk factors include cigarette smoking, diabetes, hypercholesterolemia, and metabolic syndrome.
Possible complications include arrhythmias, heart failure, and thromboembolism.

Angina Pectoris

Stable angina is the most common form, typically triggered by exertion or stress, relieved by rest or nitroglycerin.
Unstable angina is more serious and unpredictable, occurring at rest or with minimal exertion.
Variant angina (Prinzmetal's angina) is less common and caused by temporary spasm in coronary arteries.

Angina Pectoris : Blood Flow

Coronary artery disease (CAD) is the primary cause of angina, caused by atherosclerosis resulting in buildup of plaque in coronary arteries.
Risk factors include age, gender, smoking, high blood pressure, high cholesterol, and diabetes.

Acute Coronary Syndrome (ACS)

Unstable angina, NSTEMI, and STEMI are three main conditions of ACS often caused by rupture/erosion in coronary artery leading to blood clot formation
Risk factors include cigarette smoking, diabetes, hypercholesterolemia, and metabolic syndrome.
Important diagnoses include unstable angina (not permanent damage); STEMI (ST-segment elevation MI – significant damage to heart muscle); NSTEMI (non ST-elevation MI – partial blockage).

Electrical Activity of the Heart

The heart's electrical system coordinates the contractions of the atria and ventricles.
The electrical impulses originate in the sinoatrial (SA) node.
The impulses travel through specialized pathways (intermodal pathways) to the atrioventricular (AV) node, and then to the bundle of His, bundle branches, and Purkinje fibers.
The electrical activity is represented on an electrocardiogram (ECG). Key features include the P wave, PR interval, QRS complex, and ST segment.
The different phases of the action potential include 0,1,2,3,and 4

Heart Sounds

Auscultation of heart sounds (S1 and S2) and murmurs.
Assessment: Location of auscultation, and significance of sounds based on rhythmicity, intensity, pitch, quality, and timing
S1 = "lub": Closure of AV valves(mitral and tricuspid) during ventricular systole
S2 = "dub": Closure of semilunar valves(aortic and pulmonary)

Electrocardiogram (EKG)

The EKG is a graphical representation of the electrical activity of the heart.
The EKG traces the electrical activity through different leads that provides information on the heart's electrical health.
Essential waveforms on EKG include P wave, PR interval, QRS complex, ST segment, and T wave.
Standard interpretations, abnormalities, and analysis of EKG are critical for diagnosis and treatment of cardiovascular problems.

Arrhythmias

Understanding various arrhythmias, such as atrial fibrillation (AFib), atrial flutter, premature ventricular contractions (PVCs), ventricular tachycardia (VTach), and ventricular fibrillation (VFib).
Recognize the differences among these arrhythmias and their implications for clinical management.
The different types of arrhythmias, mechanisms behind them, and the corresponding ECG appearance patterns.

Myocardial Infarction (MI) Complications

Dysrhythmias are common complications, and cardiac monitoring and medication administration would be appropriate in this case.
Assessing for signs of emboli such as shortness of breath, abnormal heart sounds or neurologic deficits to help with medication administration.
Pericarditis (inflammation), Thromboembolism and postinfarction angina
Ventricular rupture
Cardiogenic shock

Heart Failure

Causes due to primary (unknown) and/or secondary reasons (chronic disease).
Understanding the pathophysiology of preload, afterload and cardiac contractility. Recognizing the common symptoms associated with heart failure, such as edema in peripheral extremities, shortness of breath, and fatigue
Evaluation of the various compensatory mechanisms and the consequent clinical presentation.

Hypertension

High blood pressure (BP).
Causes of Hypertension.
Risk factors of Hypertension.
Presenting signs of Hypertension.
Common complications of Hypertension.

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Description

This quiz covers critical aspects of cardiovascular emergencies, acute myocardial infarction (MI), and heart failure. It includes ECG images for better understanding and emphasizes the cardiovascular system's functions, including pulmonary and systemic circulation. Test your knowledge on how the heart manages blood flow and the implications of emergencies on heart function.