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CARDIAC PERIPHERAL VASCULAR BRAIN / HEART CONNECTION HEART ANATOMY REVIEW • SURROUNDS THE HEART • PERICARDIUM • PARTITIONS RIGHT AND LEFT SIDES • SEPTUM • 4 DISTINCT HEART DIVISIONS • CHAMBERS HEART FLOW CONTROLS • ALLOW DIRECTIONAL BLOOD FLOW PREVENTING BACKFLOW • VALVES • HEART’S RIGHT SIDE • PULMONARY & TRICUSPID – 3 CUSPS • HEART’S LEFT SIDE • AORTIC & MITRAL (BICUSPID) PATHY ….What can go wrong? • CONGENITAL ANOMALIES • CORONARY BLOCKAGE/IMPAIRMENT • VALVULAR DISORDERS • ANEURYSMS • THYMOMA – TUMOR OF THYMUS VEINS • BLOOD FROM UPPER BODY LOWER BODY • SUPERIOR VENA CAVA • INFERIOR VENA CAVA • OXYGENATED BLOOD TO HEART FROM LUNGS • PULMONARY VEINS ARTERIES • BLOOD TO LUNGS FOR OXYGEN • PULMONARY ARTERIES (R & L) • OXYGENATED BLOOD TO HEART • CORONARY ARTERIES (R & L) • BUILDUP OF CHOLESTEROL FATS • PLAQUE "HARDENING OF THE ARTERIES” • ATHEROSCLEROSIS RISK FACTORS OF CAD • NO CONTROL • Gender • Age • Heredity • CAN CONTROL • • • • • • • • High blood pressure Smoking High cholesterol levels Lack of proper exercise Body weight Diabetes Stress Poor Diet CAD SYMPTOMS • PAIN – CHEST, NECK AND/OR ARMS • DURATION - 3 TO 5 MINUTE OR LONGER • RESULTS - OXYGEN DEPRIVATION • OUTCOME - HEART ATTACK http://www.nhlbi.nih.gov/health/dci/Diseases/Angiopl asty/Angioplasty_During.html CAD TRIGGERS • PHYSICAL EXERTION • EATING • CHANGES IN TEMPERATURE • EXTREME EMOTION • AT REST CABG IMAGE CABG = Acronym for ? • OXYGEN RICH BLOOD TO HEART MUSCLE • LIFESPAN = 10 TO 12 YEARS • HARVEST : • VEIN - GREATER SAPHENOUS ARTERY – INTERNAL MAMMARY • RADIAL ARTERY THROMBOSIS – What is it? HEART VALVE ANATOMY HEART VALVE PROBLEMS • REGURGITATION or INSUFFICIENCY – Pulmonary venous HTN – CHF • STENOSIS – Ventricular hypertrophy – CHF VALVE FACTORS • AGE • ANTICOAGULANT USE • OCCUPATION • HEART FUNCTION & RHYTHM • VALVE SIZE & # NEEDED STERNOTOMY & MIS NORMAL HEARTBEAT • STARTS NORMAL HEARTBEAT • Sinoatrial (SA) node • RECEIVES IMPULSE • Atrioventricular (AV) node • AV NODE TRIGGERS WHAT? • Ventricular contraction • NORMAL HEARTBEAT RATE • 60 – 80 times a minute! CARDIAC DYSRHYTHMIA • Interruption of electrical conductivity between atria and ventricle • HEART BLOCK • Slow, fast or irregular heartbeats • ARRHYTHMIA • SLOW = BRADYCARDIA = < 60 bpm • FAST = TACHYCARDIA = > 100bpm • Irregular, disorganized electrical activity • ATRIAL FIBRILLATION MAZE INSTRUMENTS CARDIAC DIAGNOSTICS • Catheter advanced from Brachial/Femoral artery to heart or coronary artery • CARDIAC CATHETERIZATION • RECORD ELECTRICAL VARIATIONS • EKG • Ultrasound views cardiac structure/motion • ECHOCARDIOGRAM • Endoscopic viewing of cardiac grafts, perfusion, valves, ventricular function • TEE ( transesophageal echocardiogram) LAB STUDIES • CARDIAC ENZYMES • BLOOD WORK • ARTERIAL BLOOD GASES SPECIAL EQUIPMENT • THERMISTOR • AUTO TRANSFUSER • SLUSH • CINE MACHINE HEART FAILURE • WHO HAS IT? - 1-2% U.S. Populous = 4.9 million • WHAT CAUSES IT? ---– – – – – Cardiomyopathy Diabetes Valvular Disease Pericardial Diseases Continuous Tachycardia MI HTN • http://www.bing.com/videos/watch/video/n ejm-procedure-deployment-of-anendovascular-graft-inan/128611DDD591396E3987128611DDD 591396E3987?q=abdominal+aortic+aneur ysm+surgery&FROM=LKVR5>1=LKVR 5&FORM=LKVR27 CAROTIDENDARTERECTOMY • http://www.videomd.com/CarotidEndartere ctomy-fv-560.aspx • http://www.cts.usc.edu/videos.html • http://www.vascularsurgery.org.uk/index.p hp?option=com_content&view=section&la yout=blog&id=12&Itemid=110 • http://www.wesleymooremd.com/video/ • http://www.bing.com/videos/search?q=vas cular+surgery+video+clips&qpvt=vascular +surgery+video+clips&FORM=VDRE&adlt =strict • http://quizlet.com/6239001/surgical-technologych-23-peripheral-vascular-surgery-flash-cards/ • http://www.pluromed.com/legoo_clinical_ex.htm • http://www.rush.edu/rumc/page-R11815.html • http://www.youtube.com/watch?v=Zxqj1BcBpIg • http://www.ctsnet.org/sections/clinicalresources/ videos/index.html • http://www.smm.org/heart/videos/top.html#bypa ss • http://www.provena.org/mercy/body.cfm?id=957 • http://www.vascularprocedures.com/html/caroti d/axillofemoral.php • http://www.youtube.com/watch?v=ksjhfw_ Pcx8