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Chapter Ten
Cardiovascular System
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1
Quote
“A good exercise for the heart is bending down
and helping someone to get up.”
– Proverb
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2
Functions and Specialty/Specialist

Functions

Transportation of
substances
• To cells

Oxygen, nutrients,
other substances

Specialty


Cardiology
Specialist

Cardiologist
• Away from cells

Waste products
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3
Pulmonary and Systemic Circulation

Role and routes of:


Pulmonary
circulation
Systemic
circulation
Pulmonary and systemic circulation
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4
Pulmonary and Systemic Circulation,
(cont’d)

Vessels (vascul/o, angi/o, vas/o)
of the circulatory system

Aorta (aort/o)
 Arteries (arteri/o)
 Arterioles (arteriol/o)
 Capillaries (capillar/o)
 Venules (venul/o)
 Veins (ven/o, phleb/o)
 Venae cavae
Arteries, veins, capillaries
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5
Anatomy of the Heart (cardi/o,
coron/o)

Location



Precordium
Size
Blood supply

Coronary arteries
Coronary
arteries
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6
Anatomy of the Heart
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7
Anatomy of the Heart (cont’d)


Chambers
 Atria (atri/o)
 Ventricles (ventricul/o)
 Septa (sept/o)
Layers
 Endocardium
(endocardi/o)
 Myocardium (myocardi/o)
 Pericardium (pericardi/o)
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8
Clicker Question

The upper chambers of the heart are the:
A. arterioles
B. atria
C. venules
D. ventricles
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9
Blood Flow through the Heart

Deoxygenated blood:



 tricuspid
valve
Right ventricle  pulmonary
semilunar
valve
Pulmonary
 capillaries
arteries of the
lungs
Right atrium
Oxygenated/deoxygenated
blood
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10
Blood Flow through the Heart
(cont’d)

Oxygenated blood

Capillaries
of lungs
 pulmonary
veins

Left
atrium
 bicuspid/
mitral valve

Left
ventricle
 aortic
semilunar
valve

Aorta
Route of blood in heart
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11
Did You Know?

A good way to remember how the blood flows
through the heart valves is to memorize the
phrase “Try (tri) before you buy (bi).” In the
heart, blood flows through the tricuspid valve
and then through the bicuspid (mitral) valve.
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12
Blood Flow through the Heart
(cont’d)

Ejection fraction


Heart rate



Normal: approximately 65%
Beats per minute (BPM)
Normal: 60--100 bpm
Pulse points
Pulse points
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13
The Cardiac Cycle

Blood pressure (BP)


Sphygmomanometer
Electrical pathway




Sinoatrial node (SA)
Atrioventricular node (AV)
Bundle of His/
atrioventricular bundle
Purkinje fibers
Electrical conduction
pathways of the heart
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14
Clicker Question

The abbreviation for a normal heart rhythm is:
A. AV
B. BP
C. NSR
D. SA
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15
Terms Related to Cardiac Signs and
Symptoms


Bradycardia vs. Tachycardia
Cardiodynia

Atypical
 Ischemic



Cardiomegaly
Cyanosis
Diaphoresis
ECGs
A, normal B, bradycardia C, tachycardia
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16
Terms Related to Cardiac Signs and
Symptoms (cont’d)




Claudication
Dyspnea
Dyspnea on exertion
(DOE)
Edema




Nausea and emesis
Bruit
Murmur
Pallor
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17
Terms Related to Cardiac Signs and
Symptoms (cont’d)






Palpitations
Pulmonary congestion
Shortness of breath (SOB)
Syncope
Thrill
Venous distension
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18
Clicker Question

The term that means fainting is:
A. bruit
B. diaphoresis
C. emesis
D. syncope
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19
Terms Related to Congenital
Disorders of the Heart



Coarctation of the aorta
Patent ductus arteriosus
(PDA)
Septal defect



Atrial septal defect
(ASD)
Ventricular septal defect
(VSD)
Tetralogy of Fallot
Coarctation of the aorta
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20
Terms Related to Valvular Heart
Disease



Aortic stenosis (AS)
Mitral stenosis (MS)
Tricuspid stenosis (TS)
Valvular heart disease
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21
Terms Related to Valvular Heart
Disease (cont’d)




Mitral regurgitation
(MR)
Mitral valve prolapse
(MVP)
Orthopnea
Valvulitis
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22
Terms Related to Cardiac
Dysrhythmias


Dysrhythmia/
arrhythmia
Ectopic beats

Atrial vs. Ventricular

Fibrillation


Atrial
• Paroxysmal
Ventricular
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23
Terms Related to Cardiac
Dysrhythmias (cont’d)


Flutter
Heart block

Atrioventricular block
 Bundle branch block (BBB)


Sick sinus syndrome (SSS)
Ventricular tachycardia
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24
Did You Know?

Research results show that men and women often
experience different heart attack symptoms. Although
men are more likely to experience crushing pressure
or pain, nausea, and shortness of breath, women
may not. Many women report extreme fatigue,
weakness, dizziness, and a cold sweat, along with
shortness of breath. Unfortunately, because most
women are unaware that these symptoms may signal
a life-threatening condition, they often delay seeking
medical assistance.
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25
Terms Related to Other Disorders of
Coronary Circulation



Angina pectoris
Coronary artery
disease (CAD)
Myocardial
infarction (MI)
Angina
pectoris
Myocardial
infarction
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26
Clicker Question

Extremely rapid and irregular heartbeats:
A. ectopic beats
B. fibrillation
C. flutter
D. angina pectoris
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27
Terms Related to Other Cardiac
Conditions





Cardiac tamponade
Cardiomyopathy
Heart failure (HF)
Endocarditis
Pericarditis
Cardiomyopathy
From the CDC
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28
Did You Know?

Since 1900, cardiovascular disease has been
the number one killer in the United States
every year except for 1918. Cardiovascular
disease claims almost 10,500 more lives
each year than the next six leading causes of
death combined.
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29
Terms Related to Vascular Disorders

Arteriosclerosis




Atherosclerosis
Aneurysm
Esophageal
varices
Hemorrhoid
Atherosclerosis
From Damjanov: Pathology for the health professions, ed 3, Mosby
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30
Terms Related to Vascular Disorders
(cont’d)

Hypertension




Hypotension



Primary/essential
Secondary
Malignant
Orthostatic
Peripheral arterial
occlusion
Peripheral vascular
disorder
Complications of hypertension
From Damjanov: Pathology for the health professions, ed 3, Mosby
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31
Terms Related to Vascular Disorders
(cont’d)


Raynaud disease
Thrombophlebitis

Deep
 Superficial


Varicose veins
Vasculitis
Thrombophlebitis
From Lewis: Medical-surgical nursing, ed 7, Mosby
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32
Clicker Question

Inflammation of a vein with formation of a clot
is:
A. varicose veins
B. thrombophlebitis
C. claudication
D. Raynaud disease
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Terms Related to Benign Neoplasms


Atrial myxoma
Hemangioma
Hemangioma
From Zitelli: Atlas of pediatric physical diagnosis, ed 5, Mosby
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34
Terms Related to Malignant
Neoplasms


Cardiac myxosarcoma
Hemangiosarcoma
Cardiac myxosarcoma
From Damjanov: Pathology for the health related professions, ed 3, Mosby
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35
Clicker Question

A cancer of the cells that line the blood
vessels:
A. atrial myxoma
B. cardiac myxosarcoma
C. hemangioma
D. hemangiosarcoma
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Age Matters

Pediatrics

Congenital disorders

Geriatrics





Hypertension
CAD
MI
Arrhythmias
PVD
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Terms Related to General Diagnostic
Procedures

Blood pressure


Sphygmomanometer
Auscultation and
percussion

Stethoscope
Sphygmomanometer
From the CDC
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Terms Related to Imaging

Echocardiography



Transesophageal echocardiography
Exercise stress test
(EST)
Magnetic resonance
imaging (MRI)
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Terms Related to Imaging (cont’d)





MUGA scan
Myocardial perfusion
imaging
Positron emission
tomography (PET)
Radiography
Phlebography
MUGA scan
From Frank et al: Merrill’s atlas, ed 11, Mosby
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Terms Related to Imaging (cont’d)

Angiocardiography

Digital subtraction
angiography (DSA)
DSA
From Frank et al: Merrill’s atlas, ed 11, Mosby
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Terms Related to Imaging (cont’d)


Cardiac catheterization
Swan-Ganz catheter
Cardiac catheterization
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Terms Related to Imaging (cont’d)


Electrocardiography
(ECG/EKG)
Holter monitor
Holter monitor
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Terms Related to Laboratory Tests



Cardiac enzymes tests
Lipid profile
Phlebotomy
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Clicker Question

What is the term for a portable EKG?
A. angiocardiography
B. digital subtraction angiography
C. Holter monitor
D. myocardial perfusion imaging
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Terms Related to Cardiac
Procedures

Atherectomy





Laser angioplasty
Automatic implantable cardioverterdefibrillator (AICD)
Cardiac defibrillator
Cardiopulmonary
resuscitation (CPR)
Commissurotomy
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Terms Related to Cardiac
Procedures (cont’d)

Cardiac pacemaker
Pacemakers
From Frank et al: Merrill’s atlas, ed 11, Mosby
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Terms Related to Cardiac
Procedures (cont’d)

Coronary artery bypass graft (CABG)
CABG
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Terms Related to Cardiac
Procedures (cont’d)




Extracorporeal circulation (ECC)
Heart transplantation
Left ventricular assist device (LVAD)
Minimally invasive direct coronary artery
bypass (MIDCAB)
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Did You Know?

Every year more than 2000 Americans receive a
heart transplant. Many more candidates die
each year for lack of donor organs. Research
continues in the development of an artificial
heart.
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50
Clicker Question

The C in CABG stands for:
A. cardiac
B. circulation
C. coronary
D. corporeal
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Terms Related to Cardiac
Procedures (cont’d)

Percutaneous transluminal coronary
angioplasty (PTCA)

stent
PTCA
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Terms Related to Cardiac
Procedures (cont’d)


Pericardiocentesis
Port-access coronary artery bypass (PACAB)
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Terms Related to Cardiac
Procedures (cont’d)


Radiofrequency
catheter ablation
(RFA)
Transmyocardial
revascularization
(TMR)


Angiogenesis
Valvuloplasty
Valvuloplasty
From Black and Hawks, Medical-surgical nursing, ed 7, Saunders
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Terms Related to Vascular
Procedures





Endovenous laser ablation (EVLT)
Hemorrhoidectomy
Peripherally inserted central catheter (PICC)
Phlebectomy
Sclerotherapy

Microsclerotherapy
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Clicker Question

What is the term for a surgical puncture of the
sac surrounding the heart?
A. RFA
B. TMR
C. PTCA
D. pericardiocentesis
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56
Pharmacology





Angiotensin-converting enzyme (ACE)
inhibitors
Angiotension II receptor blocker (ARB) drugs
Antiarrhythmic drugs
Anticoagulants
Antihyperlipidemics
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Pharmacology (cont’d)



Beta-blockers
Calcium channel blockers (CCBs)
Diuretics
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Pharmacology (cont’d)

Nitrates (antianginals)


Routes of administration
• Sublingual
• Intravascular
• Transdermal
Thrombolytics
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Clicker Question

Which type of drug is used to lower
cholesterol levels?
A. antihyperlipidemics
B. ACE inhibitors
C. beta-blockers
D. nitrates
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Sort these terms into their correct
categories
Terms
1. syncope
2. extracorporeal circulation
3. tetralogy of Fallot
4. phlebotomy
5. diastole
Categories
__ A+P
__ Pathology
__ Diagnostic Procedures
__ Therapeutic
Interventions
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Parting Thought
“The challenge is in the moment; the time is
always now.”
–James Baldwin
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