Week 4
Chapter 35
Care of Patients with Cardiac Problems
*alteration in Perfusion.
Cardiac Vocabulary Refresher- (videos in speaker notes)
Path of Blood Flow:
Diastole:
Systole:
Cardiac Output:
Stroke Volume:
Preload:
Afterload:
Heart Rate:
Ejection Fraction:
Pulse Pressure: Difference between the systolic and diastolic pressures.
• A BP of 122/78 has a PP of 44 (will discuss more next week)
Cardiac volume, stroke volume, EDV, ESV, Ejection Fraction: https://www.youtube.com/watch?v=vFRkSB46bl8
Animation of Blood Flow through the Heart (2:56): https://www.youtube.com/watch?v=oHMmtqKgs50
TED Ed on what the heart does (4:27) https://www.youtube.com/watch?v=ruM4Xxhx32U
, Heart Failure (aka Pump failure)
• Heart cannot effectively move the blood throughout the body
Major Types of Heart Failure
1. Left-sided
2. Right-sided
3. High-output failure
Right sided vs Left sided heart failure (8:28) https://www.google.com/search?q=how+do+you+remember+left+vs+right+sided+heart+failure&ie=utf-8&oe=utf-8&client=firefox-b-ab#kpvalbx=1
Causes of HF
• Hypertension
• Coronary artery disease
• Cardiomyopathy
• Substance abuse (alcohol / illicit/prescribed drugs)
• Valvular disease
• Congenital defects
• Cardiac infections / inflammations
• Dysrhythmias
• Diabetes mellitus
• Smoking/tobacco use
• Family history
• Obesity
• Severe lung disease
• Sleep apnea
• Hyperkinetic conditions (e.g., hyperthyroidism
Left-Sided Heart Failure (CHF)
Systolic heart failure: ventricle can’t contract / pump blood adequately.
Caused by: injury to heart / by normal process of aging.
• Aging = stiffness, thickening of smooth muscle layers in arteries.
• heart muscle thickens = Hypertrophy
• EF, CO
• Blood starts to build up in lungs,
At risk for sudden cardiac death
Diastolic heart failure: left ventricle can’t relax/ unable to fill with enough
blood for adequate CO (preserved left ventricle function)
• not able to relax during diastole
• cant fill enough, gets stiff, EF normal,
• but in time ventricle wears out has to work against so much pressure
• 20-40% of all hf older adults, women with chronic htn
Assessment
• Fluid backs up into lungs,
• tissues don’t perfuse, low cardiac output
• Body is starved for O2 & nutrients, perfusion
Common Assessment Findings:
• Shortness of Breath activity tolerance
• Dyspnea at night, (orthopnea) dt pulmonary pressure/congestion, sleep in recliner at night
• paroxysmal nocturnal dyspnea wake suddenly at night breathless sit up hang feel over side of
bed
Chapter 35
Care of Patients with Cardiac Problems
*alteration in Perfusion.
Cardiac Vocabulary Refresher- (videos in speaker notes)
Path of Blood Flow:
Diastole:
Systole:
Cardiac Output:
Stroke Volume:
Preload:
Afterload:
Heart Rate:
Ejection Fraction:
Pulse Pressure: Difference between the systolic and diastolic pressures.
• A BP of 122/78 has a PP of 44 (will discuss more next week)
Cardiac volume, stroke volume, EDV, ESV, Ejection Fraction: https://www.youtube.com/watch?v=vFRkSB46bl8
Animation of Blood Flow through the Heart (2:56): https://www.youtube.com/watch?v=oHMmtqKgs50
TED Ed on what the heart does (4:27) https://www.youtube.com/watch?v=ruM4Xxhx32U
, Heart Failure (aka Pump failure)
• Heart cannot effectively move the blood throughout the body
Major Types of Heart Failure
1. Left-sided
2. Right-sided
3. High-output failure
Right sided vs Left sided heart failure (8:28) https://www.google.com/search?q=how+do+you+remember+left+vs+right+sided+heart+failure&ie=utf-8&oe=utf-8&client=firefox-b-ab#kpvalbx=1
Causes of HF
• Hypertension
• Coronary artery disease
• Cardiomyopathy
• Substance abuse (alcohol / illicit/prescribed drugs)
• Valvular disease
• Congenital defects
• Cardiac infections / inflammations
• Dysrhythmias
• Diabetes mellitus
• Smoking/tobacco use
• Family history
• Obesity
• Severe lung disease
• Sleep apnea
• Hyperkinetic conditions (e.g., hyperthyroidism
Left-Sided Heart Failure (CHF)
Systolic heart failure: ventricle can’t contract / pump blood adequately.
Caused by: injury to heart / by normal process of aging.
• Aging = stiffness, thickening of smooth muscle layers in arteries.
• heart muscle thickens = Hypertrophy
• EF, CO
• Blood starts to build up in lungs,
At risk for sudden cardiac death
Diastolic heart failure: left ventricle can’t relax/ unable to fill with enough
blood for adequate CO (preserved left ventricle function)
• not able to relax during diastole
• cant fill enough, gets stiff, EF normal,
• but in time ventricle wears out has to work against so much pressure
• 20-40% of all hf older adults, women with chronic htn
Assessment
• Fluid backs up into lungs,
• tissues don’t perfuse, low cardiac output
• Body is starved for O2 & nutrients, perfusion
Common Assessment Findings:
• Shortness of Breath activity tolerance
• Dyspnea at night, (orthopnea) dt pulmonary pressure/congestion, sleep in recliner at night
• paroxysmal nocturnal dyspnea wake suddenly at night breathless sit up hang feel over side of
bed
