Cardiac Review
● Circulation of blood in heart
○ RATLAB
■ Right Atrium (to right ventricle)
■ Through Tricuspid valve
■ Left Atrium (to left ventricle)
■ Body (via aorta)
○ Right atrium full of CO2 and deoxy blood
○ Right ventricle begins to oxygenate blood and lose CO2
○ Pulmonary artery brings deoxy blood to lungs
○ Lungs oxygenate blood
○ Pulmonary vein brings oxy blood towards heart
○ Mitral valve is gate only for oxy blood to pass
○ Left atrium brings back oxy blood into heart
○ Left ventricle supplies oxy blood to rest of body
LVAD
● LVAD patients have weak left ventricle
● Symptoms
○ Renal failure, poor perfusion, fluid buildup → heart failure, etc.
● LVAD pump from aorta via outflow graft
○ The pump pressurizes blood → aorta → body
● Acceptable MAP for LVAD pt: 70-90
● Vitals
○ Continuous flow
■ No pulse, no problem
○ Difficult to obtain BP
■ Unreliable because continuous flow
○ Pulse ox also unreliable due to no variability
○ Instead, look at other examinations
■ Check bgl, end tidal CO2, respirations
■ Skin color, temp, mental status
Doppler
● Used to take BP on LVAD pt
● Apply conduction gel on elbow area
● Power on Doppler and put wand in the gel to find the “swish”
○ Swish sound is pulse
● Place manual cuff above same elbow
● Use Doppler like stethoscope
○ Loss of swish/pulse is systolic
○ Return of swish/pulse is diastolic
● Can also use radial pulse
● Circulation of blood in heart
○ RATLAB
■ Right Atrium (to right ventricle)
■ Through Tricuspid valve
■ Left Atrium (to left ventricle)
■ Body (via aorta)
○ Right atrium full of CO2 and deoxy blood
○ Right ventricle begins to oxygenate blood and lose CO2
○ Pulmonary artery brings deoxy blood to lungs
○ Lungs oxygenate blood
○ Pulmonary vein brings oxy blood towards heart
○ Mitral valve is gate only for oxy blood to pass
○ Left atrium brings back oxy blood into heart
○ Left ventricle supplies oxy blood to rest of body
LVAD
● LVAD patients have weak left ventricle
● Symptoms
○ Renal failure, poor perfusion, fluid buildup → heart failure, etc.
● LVAD pump from aorta via outflow graft
○ The pump pressurizes blood → aorta → body
● Acceptable MAP for LVAD pt: 70-90
● Vitals
○ Continuous flow
■ No pulse, no problem
○ Difficult to obtain BP
■ Unreliable because continuous flow
○ Pulse ox also unreliable due to no variability
○ Instead, look at other examinations
■ Check bgl, end tidal CO2, respirations
■ Skin color, temp, mental status
Doppler
● Used to take BP on LVAD pt
● Apply conduction gel on elbow area
● Power on Doppler and put wand in the gel to find the “swish”
○ Swish sound is pulse
● Place manual cuff above same elbow
● Use Doppler like stethoscope
○ Loss of swish/pulse is systolic
○ Return of swish/pulse is diastolic
● Can also use radial pulse
