Download INTRO TO THE CARDIOVASCULAR SYSTEM UNIT 1

INTRO TO THE
CARDIOVASCULAR SYSTEM
Nadine Gauthier, MD
Division of Cardiology
Content Expert - Cardio
OUTLINE
• What to expect during the next 5 weeks…
• Cardiology 101
– Basic anatomy
– Physiology of the cardiovascular system
– Functional differences between the right and
left ventricle
– Cardiovascular medicine
PERSPECTIVE
Oncology: 1 Week
Unit 1: 18 Weeks + 1 Exam Week
The New University of Ottawa
Undergraduate Medical Curriculum
Cardiovascular: 5 Weeks
Respiratory/ENT: 5 Weeks
Lymphoma: 1 Week
Thrombosis: 1 Week
Renal: 4 Weeks
Homeostasis: 1 Week
The Cardiology “Block” of Unit 1
Week
1
Normal
2
CHF
3
CAD
4
Valves
5
Congenital
Mon
Tue
Intro to Unit + “Block” (1h)
Electrical Activation of the
Heart (2h)
Myocardial Contraction (1h)
CBL 1 (2h)
Physiology of Abnormal
Ventricular Function (1h)
Heart Failure (1h)
Introduction to Cardiac Imaging
Part 1 (2h)
CBL 1 (2h)
Ischemia (1h)
Atherosclerosis (1h)
Myocardial Ischemia Testing
(2h)
CBL 1 (2h)
Physiology of Valvular Heart
Disease (2h)
Pulmonary Hypertension (1h)
Surgery of Valvular Heart
Disease (1h)
CBL 1 (2h)
Cardiovasc. Embryology (2h)
Physiology of Congenital Heart
Disease (1h)
Introduction to Cardiac Imaging
Part 2 (1h)
CBL 1 (2h)
Wed
Thu
Fri
Ventricular Function (1h)
Smooth Muscle + Coronary
Physiol (1h)
ECG Seminar #1 (2h)
Heart Anatomy (1.5h)
Heart Histology (1.5h)
Autonomic Nervous System (1.5h)
Acute Decompensated Heart
Failure (1h)
Shock (1h)
ECG Seminar #2 (2h)
Pressure-Volume Loops (1.5h)
Fluid Dynamics (1.5h)
Cardiomyopathy (1.5h)
Acute Coronary Syndromes (1h)
Antithrombotic and Reperfusion
Therapy (1h)
ECG Seminar #3 (2h)
Vessel Anatomy (1.5h)
Vessel Histology (1.5h)
Ischemia and Infarction (1.5h)
Endocarditis (1h)
Pericardial Disease (1h)
Mechanisms of Arrhythmia (2h)
Echo Lab: Heart and Valve
Function (1.5h)
Pathology of Valve Disease (1.5h)
Aortic Pathology and PVD (1.5h)
CBL 2 (3h)
Treatment of Arrhythmia (1.5h)
Arrhythmia Review (1.5) Clinical
Problems in Pediatric Cardiology
(1.5h)
CBL 2 (3h)
Outline of Congenital Heart
Disease (2h)
ECG Seminar #4 (2h)
PLUS:
Whole-Class Teaching; Part-Class Teaching; Small-Group Teaching
CBL 2 (3h)
Week Review
(1h)
CBL 2 (3h)
Week Review
(1h)
CBL 2 (3h)
Week Review
(1h)
Self-Learning
Modules (SLMs)
1-2/week
Society,
Individual,
Medicine
(SIM)
2h every Tue AM
Physician Skills
Development
(PSD)
3h every Thu PM
Week Review
(1h)
Week Review
(1h)
Electives:
1-2/week
TEACHING AND LEARNING
• Different types of teaching sessions
– Lectures, workshops
– SLM, SIM, PSD, Lab
– CBL
• Different teaching styles
• Be prepared, be engaged
• Resources
– Lilly, LS, éd., Pathophysiology of Heart
Disease, 5e édition, 2011
CARDIO BLOCK
• What students have liked best about
Cardio:
– Structure, organization, flow
– CBL tutors, lecturers, teachers
– Textbook: Lilly
ANATOMY
• A complex organ, more than meets the eye!!!
• This is not what the human heart looks like…
• What the heart
really looks like:
Size :
Human fist
Weight :
300 g (women)
325 g (men)
HEART POSITION
ANATOMY
THE HEART IS A PUMP
•
•
•
•
Inlets
Priming Chambers
Valves
Pumping
Chambers
• Valves
• Outlets
THE HEART IS A DOUBLE PUMP
Right Heart
Left Heart
Inlet
Venae Cavae
Pulmonary veins
Intake ports
Right atrium
Left atrium
Valves
Tricuspid valve
Mitral valve
Motor
Right ventricle
Left ventricle
Valves
Pulmonic valve
Aortic valve
Discharge ports
Pulmonary artery
Aorta
•Triggered and coordinated by an integrated electrical system…
COMPLEX MATCHED ELECTRICAL
AND MECHANICAL ACTIVITY
Distinct territories of coupled
electrical and mechanical activity
PHYSIOLOGY
• Heart main function: mediates blood
oxygenation
Nutrients + O2
↓
Energy + CO2
HOW DOES IT DO THAT?
In 2 steps:
1. It receives (relatively) deoxygenated (and
CO2-rich) blood from the body and
pumps it to the lungs;
2. It receives oxygenated (and CO2-poor)
blood from the lungs and pumps it to the
body
QUESTION 1: TRUE OR FALSE?
Venous (“deoxygenated”) blood is blue:
QUESTION 1: TRUE OR FALSE?
Venous (“deoxygenated”) blood is blue:
FALSE!
Venous blood is dark red:
Arterial blood is bright red:
QUESTION 2
• How many times will the average heart
beat over the course of a lifetime?
1.
2.
3.
4.
3 million times
3 billion times
3 trillion times
3 quadrillion times
QUESTION 3
•
What is the lowest recorded resting
(physiologic) heart rate recorded in
human?
1.
2.
3.
4.
48 bpm
38 bpm
28 bpm
18 bpm
Martin Brady (UK, b. 24 March 1969) who was tested at the Guernsey
Chest and Heart Unit, Channel Islands, UK on 11 August 2005.
CARDIOVASCULAR MEDICINE
• So much emphasis is placed on the fancy
and the expensive…
CARDIOVASCULAR MEDICINE
• But so much of what cardiovascular
medicine has to offer is simple and cheap:
CARDIOVASCULAR MEDICINE
• Diagnosing heart disease by history:
– “Doctor, I get a squeezing discomfort in the
center of my chest every time I carry the
laundry back up from the basement.”
THE STETHOSCOPE…
• Diagnosing heart disease on physical
examination:
PHYSICAL EXAM SKILLS
•
•
•
•
Practice makes perfect
Be patient
Easier to learn with pathology
Use the resources available to you
– Heart sounds CD and websites
– Harvey the manequin (SIM centre)
– Important website (designed by a local
cardiologist)
http://www.cvtoolbox.com
CARDIOVASCULAR MEDICINE
• Diagnosing heart disease with simple
investigations: ECG
CARDIO SKILLS TEACHING
WEBSITE
• www.teachingmedicine.com
• Create a login/password
• You will receive an email/link inviting to
participate in this strongly recommended
online modules
• Non-mandatory modules
– Week 1:
• Module 1: Basic Electric Stuff
• Module 2: Analyze the Waveforms
• http://www.teachingmedicine.com/faculty.aspx
CARDIOVASCULAR SPECIALTY MEDICINE
• Postgraduate Training
• Not as bad as it seems…
“Basic Training” = 6 years
Internal Medicine
Additional Training = 1-3 years
Cardiology
Cardiac Surgery
Anesthesiology
Card
Anesth
THE HEART IS #1



It is a vital organ
Simple yet complex
It is a selfless organ

Leading cause of death in both men and
women



#1 = CV disease
#2 = Infectious disease
#3 = malignancy
#1 Organ In Spoken English
Happy
Light-hearted
Take heart
Heartened
Does your heart good
Warms the cockles of your heart
Love
Sweetheart
Heartthrob
Steal your heart
Kind/Generous
Big-hearted
From the heart
Heart in the right place
Heart of gold
Cold hands, warm heart
Sincerely
Heartfelt
Whole-hearted
From the bottom of my heart
Strong/Brave
Lion-hearted
Brave-hearted
Compassion/Concern
Don’t have the heart to
My heart goes out to you
Soft place in my heart
Tug at your heartstrings
Excited/Frightened
Heart skipped a beat
Heart in your throat
Heart-pounding
Sad
Heavy-hearted
Disheartened
Heartbroken
Heartache
Broken hearted
Cowardly/Weak
Chicken-hearted
Faint-hearted
Med School
Set your heart on
Eat your heart out
Learn it by heart
Cross your heart
Keep heart
#1 ORGAN IN MOVIES
• Of 4631 movies (1900-2003) containing
body parts in their titles:
– Heart(s)
– Blood
– Eye(s)
985
651
633
21.3%
14.1%
13.7%
#1 ORGAN IN MUSIC
• Of 341,145 songs (1850-2003) containing
body parts in their titles:
– Heart(s)
– Eye(s)
– Head
96,989
65,985
37,281
28.4%
19.3%
10.9%
EXAMPLES: “WINNERS”
• Academy Awards for Best Song
– “A Dream Is a Wish Your Heart Makes” (Snow White)
– “My Heart Will Go On” (Titanic)
• Number 1 Hits
– 1972: “Heart of Gold” (Neil Young)
– 1987: “Open Your Heart” (Madonna)
– 1989: “Cold Hearted” (Paula Abdul)
EXAMPLES: OTHERS
• “Achy Breaky Heart”
– Like father, like daugher
• “Please Bypass This Heart”
• “I’ve Been Flushed from the Bathroom of Your
Heart”
• “I Don’t Want Your Body if Your Heart’s Not in It”
• My Heart Will Go On was also a #1 hit in 1998
FINAL THOUGHTS
• CBL tutors are first-line resources for
questions about content
• Questions about exam format
– Unit Chair
• Other questions: [email protected]
– cc: class president(s)
NO SUCH THING AS A LITTLE
HEART ATTACK
QUESTIONS?
• HAVE FUN !!!
• ASK QUESTIONS !!!
[email protected]