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T H E H E A R T Heart Diagram Label FUNCTION TO PRESSURIZE THE BLOOD AND CAUSE IT TO FLOW THROUGH THE VESSELS. LAYERS OF THE HEART PERICARDIUM- A DOUBLE LAYERED SAC THAT COVERS THE HEART. INSIDE THE SAC IS SEROUS FLUID WHICH PREVENTS FRICTION. • MYOCARDIUM- THE HEART MUSCLE ITSELF. (THE THICKEST LAYER). • ENDOCARDIUM- LINES THE HEART. WHAT IS PERICARDITIS? • AN INFLAMMATION OF THE PERICARDIUM • USUALLY INFLAMMATORY OR VIRAL • NOT USUALLY BACTERIAL • DECREASED PRODUCTION OF SEROUS FLUID • CAUSES A RUSTLING SOUND, A FRICTION RUB PROBLEM IF THE HEART CONTINUES TO RUB, THIS CAN EXERT EXCESS PRESSURE & CAUSE HEART FAILURE. WHAT IS ENDOCARDITIS? • INFLAMMATION OF THE ENDOCARDIUM • USUALLY THE ENDOCARDIUM COVERING THE HEART VALVES • A BACTERIAL INFECTION ANATOMY OF THE HEART 4 CHAMBERS: • 2 SUPERIOR, THIN-WALLED ATRIA • 2 INFERIOR, THICK-WALLED VENTRICLES HEART VALVES PREVENT THE BACKFLOW OF BLOOD (Tricuspid valve, pulmonary valve, bicuspid valve, Aortic valve) animation of heart valves find the heart with a virtual stethescope http://www.smm.org/heart/heart/stet h.htm VALVE PROBLEMS 1. INCOMPETENT VALVE THE VALVE OPENS BUT DOES NOT CLOSE COMPLETELY. BACKWARD LEAKAGE OCCURS. THE HEART WORKS HARDER & THIS CAN LEAD TO HEART FAILURE. 2. VALVULAR STENOSIS • A STIFF VALVE • DOES NOT OPEN ALL THE WAY • MOST OFTEN DUE TO A SERIOUS BACTERIAL INFECTION • BACTERIA CAUSE FORMATION OF SCAR TISSUE ON THE VALVE. NORMAL AORTIC VALVE AORTIC STENOSIS WITH CALCIFICATION Tx VALVE REPLACEMENT: EITHER MECHANICAL MECHANICAL MITRAL VALVE REPLACEMENT PATHWAY OF BLOOD THROUGH THE BODY (valves not included) SUPERIOR & INFERIOR VENA CAVA & CORONARY VEINS RIGHT ATRIUM RIGHT VENTRICLE PULMONARY ARTERY LUNGS Pulmonary veins LEFT ATRIUM LEFT VENTRICLE AORTA ARTERIOLES Capillary (TISSUES) venule to veins Please follow the path of circulation through the heart in the link below. http://www.smm.org/heart/heart/pumping.htm BLOOD SUPPLY TO THE MYOCARDIUM THE HEART IS NOT NOURISHED BY THE BLOOD THAT PASSES THROUGH IT. CORONARY ARTERIES SUPPLY O2 RICH BLOOD B. MYOCARDIAL INFARCTION (MI) • A HEART ATTACK • PART OF THE MYOCARDIUM DIES • DUE TO PROLONGED LACK OF BLOOD & O2 • SCAR TISSUE FORMS • SCAR TISSUE CANNOT CONTRACT • HEART BECOMES STIFF • WORST MI? • THE LEFT VENTRICLE FACTS 1 MILLION DIE FROM HEART DISEASE IN THE U.S. EACH YEAR #1 CAUSE OF DEATH IN THE U.S. MOST IMPORTANT Sx? CHEST DISCOMFORT THAT LASTS FOR MORE THAN A FEW MINUTES Tx 1. CLOT BUSTERS 2. ANGIOPLASTY 3. BY-PASS CLOT BUSTERS • TPA & STREPTOKINASE • MUST BE GIVEN WITHIN THE FIRST 90 MINUTES • WHY? • TISSUE DIES BY THIS TIME • WHEN SHOULD YOU NOT GIVE A CLOT BUSTER? • WHEN THERE IS A CHANCE OF SURGERY ANGIOPLASTY • ALSO CALLED BALLOON SURGERY • AN INFLATED BALOON IS PRESSED AGAINST THE WALL OF THE ARTERY TO COMPRESS THE OBSTRUCTION (PLAQUE) • ABOUT 2/3 FAIL WITHIN ONE YEAR OCCLUDED ARTERY BLOOD BLOOD VESSEL PLAQUE BALLOON TO BE INFLATED HEART CONDITIONS A. ANGINA PECTORIS- CHEST PAIN DUE TO LACK OF O2 TO THE MYOCARDIUM 1. 2 CAUSES: SPASM OF THE CORONARY ARTERIES. COLD CAN TRIGGER. • Tx: NITROGLYCERINE 2. TOO MUCH PHYSICAL DEMAND • Tx: SLOW DOWN BY-PASS SURGERY • IS THE MOST DANGEROUS • CHEST WALL IS CRACKED OPEN • A VEIN IS USED TO REPLACE THE BLOCKED AREA OF THE ARTERY • USUALLY A VEIN FROM THE LEG • • ONLY GOOD FOR ABOUT 10 YEARS Prevention Therapy Recommendations: A baby aspirin each day Who should avoid taking aspirin? 1. anyone with an allergy to aspirin 2. anyone with asthma 3. anyone with stomach ulcers 4. anyone with bleeding disorders 5. anyone with reduced liver or kidney function 6. anyone with uncontrolled high blood pressure