Download HEART FUNCTION AND HEART SOUNDS

HEART FUNCTION AND
HEART SOUNDS
What is the Heart
• The heart is a pear shaped muscular
organ with chambers. It pumps blood
received from the veins into the arteries.
MUSCLE OF HEART
• Apex (bottom) is the point of the heart which
angles down and to the left
– Rests on the diaphragm.
• Base (top) is the broader part, which is just
behind the sternum.
• Pericardium is the membranous sac that
encloses the heart.
– Pericardial fluid lubricates the heart as it beats
within the pericardium
• Myocardium is the cardiac muscle.
– Makes up the walls of the heart
HEART FACTS
• The location of the heart is in the mediastinum of the
thoracic cavity
• Heart is enclosed in double layered membrane the
pericarduim
• It has four chambers 2 ventricles –right and left and 2
atriums- right and left
• There are 4 valves – tricuspid, pulmonic, mitral, aortic
• Papillary muscles tether the tricuspid and mitral valves,
when blood is pumped into the ventricles they relax
,when blood is pushed into pulmonic or aorta they
contract.
Heart facts ctnd…
• Coronary arteries supply the myocarduim
with oxygenated blood while coronary
veins remove deoxygenated blood from
the myocarduim.
Blood Flow
• As the vein is carrying the deoxygenated blood it enters
the right atrium where it contracts and opens the
tricuspid valve leading to the right ventricle, the right
ventricle contracts which leads to the opening of
pulmonic valve, blood goes thru the pulmonic valve and
enters the pulmonary artery. The deoxygenated blood
then enters the lung capillaries where gas exchange
occurs O2 inhaled;CO2 exhaled. The blood is now
oxygenated and enters the left atrium where there will be
contraction and opens the mitral valve and blood flows
into the left ventricle which contracts and opens the
aortic valve. The oxygenated blood goes into the aorta,
there the aorta leads the blood to the organs in the body
and nourishes the body..
HEART SOUNDS
• During atrial systole the atrium contracts
and tops off the volume in the ventricle
with only a small amount of blood. Atrial
contraction is complete before the
ventricle begins to contract. Closure of the
AV Valves produce the first sound LUBB.
The Lubb sound can be heard best in the
tricuspid and mitral valves.
HEART SOUNDS CTND…..
• The semilunar valves are located at the
base of the pulmonary trunk and the aorta.
Blood is bieng taken out of the ventricles,
this prevents the backflow of blood from
the arteries into the ventricles. The closure
of these valves produces the second heart
sound DUBB, its best heard over pulmonic
and aortic valve/region.
MORE SOUND FACTS
• Systole is contraction, while diastole is
when blood is dilated from an atrium or
ventricular, its relaxing rather than
contracting.
• LUBB has longer duration of a loud sound,
while DUBB is shorter with a sharp sound
DIASTOLE/SYSTOLE
Clinical
• Diastolic Heart Failure
– Trouble relaxing between beats is a growing cause of
heart failure
• Why the heart can’t relax?
– Open space inside the ventricles can be restricted by heart
muscle that “bulks up” due to overwork or other causes or that
stiffens and loses it flexibility.
– Symptoms:
• Shortness of breath with mild activity, such as easy walking
• Difficulty breathing, especially when lying down
• Swollen legs and feet.
Treatment
• Fluid control
– Limiting the amount of salt (sodium) in your diet
– watching how much you drink can ease breathing, reduce
swelling, and lighten heart’s workload.
• Pressure control
– The long-term damage wrought by high blood pressure can lead
to diastolic heart failure. That’s why controlling blood pressure is
one of the best things can be done to avoid or control this
condition.
• Exercise
– The breathlessness and fatigue brought on by activity often
people with diastolic heart failure to become less and less active.
– It actually makes the problem worse. A tailored exercise program
can strengthen the heart, slow your heart rate, and improve the
condition of muscles in the heart and throughout the body.
Drug Therapy
• Diuretics (water pills) to get rid of excess fluid
• Beta blockers to slow the heart rate. Fewer
beats per minute means more time for the
ventricles to fill with blood between beats
• Calcium-channel blockers and long-acting
nitrates to relax blood vessels, especially those
that feed the heart muscle
• ACE inhibitors or angiotensin-receptor
blockers to reduce blood pressure and reverse
some of the physical changes that lead to
thickening of the heart muscle.