a.

Right Atrium – collects the oxygen-poor blood from the body

“CARDIOVASCULAR” and then drains the blood into the right ventricle.
b. Right Ventricle – pumps the blood low in oxygen to the lungs.
HEART: The lungs then refill the blood with oxygen.
 Organ c. Left Atrium – receives oxygenated blood from the lungs and
 Muscular (contract and relax) pumps it to the left ventricle.

 Cone-shaped d. Left Ventricle – major muscles/ pushes oxygenated blood in

 Fist-size your aorta, from which the blood is pumped to the entire body.

 Bigger the heart, weaker the muscle

HEART VALVES
 Faster pump- chest pain
 Structures that prevent back flow (abnormal movement
of heart) of blood.
LOCATION:
 Heart: center at the chest tilted towards the left.
2 ATRIOVENTRICULAR VALVES (AV)
 Cardiac Apex (Tip): 5th intercostal space Left
 Found between atrium and ventricle.
Midclavicular Line
(S1 – Systole -close contraction)
RIGHT SIDE:
PROTECTION:
 Tricuspid valve (found in the middle or left atrium and
a. Sternum (breastbone)
left ventricle)
b. Ribs
LEFT SIDE:
c. Costal cartilages
 Bicuspid/Mitral Valve (found in the middle or left
atrium and left ventricle)
FUNCTION:
 Pump oxygenated blood to the body
2 SEMILUNAR VALVES
 Located in the ventricle and major artery
2 PHASES OF CARDIAC MOVEMENT:
(S2 – Dub – Diastole – close relaxation)
a. Systole – contraction, ejection
RIGHT SIDE:
b. Diastole – relaxation, filling
(The rest of the body receives blood flow during systole except  Pulmonary Valve (found in the right ventricle and

HEART. Heart receives during DIASTOLE) pulmonary artery)

(Every time the RV relaxes, the pulmonary valve close)

VOLUMES OF BLOOD LEFT SIDE:

a. Stroke Volume – amount of blood ejected by the heart per  Aortic Valve (found in the left ventricle and aorta)

heartbeat (60-70 ml). (Every time the LV relaxes, the aorta valve closes)

b. Cardiac Output – amount of blood ejected by the heart in

one full minute (5-6 L/min) NORMAL ADULT CIRCULATION
(PERIPHERAL)

CHAMBERS AND SIDES Deoxygenated blood travels in veins – Vena Cava (Superior,

Sides Inferior) – RA – RV – Tricuspid Valve – Pulmonary Artery –

a. Right Side – deoxygenated blood flows Lungs (Gas exchange) – Oxygen – Pulmonary Vein – Heart –

b. Left Side – oxygenated blood flows LA – LV -Bicuspid Valve – Aorta – Aortic Valve – Arterioles
– Capillaries (Gas exchange) – Veins – Heart – Vena Cava

Chambers
CARDIAC CONDUCTION SYSTEM  Angiotensin II – Adrenal Cortex – Aldosterone –
 Electrical activity (came from electrolytes) (Sodium, reabsorb Na and H20 – Edema -increase the fluid -
Potassium, Calcium) increase BP -increase HF

3 PROPERTIES: PHARMACOLOGY
1. Automaticity – start A. Digitalis / Digoxin / Lanoxin
2. Conductivity – ability to transmit electrical impulses  drug known as cardiac glycoside
3. Excitability – ability to respond  (+) inotropic effect - strengthen cardiac contraction
(If the heart is electrified, the heart will contract)  (-) chronotrophic effect - decrease heart rate

 SINOATRIAL NODES (SA NODE) – primary NURSING INTERVENTION

pacemaker (60-100 bpm/min) ---- a. Monitor for serum potassium levels (N: 3.5-5.5) -
ATRIOVENTRICULAR NODES (AV NODE) – decrease potassium - increase toxicity
secondary pacemaker (40-60 bpm/min) ---- Bundle of b. Auscultate the apical heart rate in one full minute (<60 -
HIS – 2 types (Left and Right bundle branches) ---- hold - call the physician
Purkinje Fibers >60 – give)
c. Monitor for toxicity “(BANDAV)”
NORMAL ECG: SINUS RHYTHM B- radycardia
 P -atrial depolarization (CONTRACTION) A- norexia
 QRS – ventricular depolarization N- ausea and Vomiting
 ST – flat/isoelectric D- iarrhea
 T – ventricular repolarization (RELAX) A- bnominal pain
V- isual disturbances (halo around light)

ANTIDOTE: DIGIBIND / Digoxin Immune Fab

B. ACE Inhibitors - (ends with pril) / block RAAS

 block the conversion of ANGIO I to ANGIO II
 Fast acting, short duration
HEART FAILURE  captopril, enalapril, Visinopril
 Weakness of cardiac muscle (myocardium)  !WATCH OUT FOR: decrease bp and cough!
 Pump failure
 Complication! (Not a primary illness) C. ARBS (ANGIOTENSIN 2 RECEPTOR
BLOCKERS) - (ends with sartan)
PATHOPHYSIOLOGY  block the angiotensin 2
 HF – decrease contraction – decrease carbon dioxide  Long acting
– decrease renal blood flow – release a hormone  losartan, valsartan, telmisartan
(RENIN) – convert to Angiotensin to Angiotensin I –  !WATCH OUT FOR: decrease bp!
Angiotensin II – Vasoconstrictor – Increase BP

D. Diuretics - remove water and electrolytes

  decrease BP 3. Orthopnea - difficulty of breathing when lying
 We can give three types of diuretics flat/supine {HALLMARK FEATURE OF HF}

1. Loop Diuretics 4. PND (Paroxysmal Nocturnal Dyspnea) - *example pt

- Furosemide (Lasix) strongest of diuretics, remove everything waking up in the middle of the night due to drowning
(water, sodium,chloride, potassium, magnesium, calcium, feeling
phosphate)
Watch out for: OTOTOXICITY (deafness) 5. Cough – frothy (bubbles, sticky), blood-stinged sputum

2. Thiazide Diuretics 6. Pulmonary edema - fluid accumulation in the alveoli

- Hydrochlorothiazide (Diuril)
Remove: Water, Na, Cl, K,Mg, Phosphate, Potassium 7. Pleural effusion - fluid accumulation in the pleural
EXCEPT: Calcium space
(Pleural space- the protection in the lungs)
Watch out for: HYPERGLYCEMIA, HYPERURICEMIA,
HYPERCALCEMIA DIAGNOSTIC
GOLD STANDARD: 2D ECHO (Echocardiogram)
3. K+ sparing  can measure contraction and volume
- Spironolactone (Aldactone)
Remove: H20, Na, Cl, Mg, Phosphate
EXCEPT: Potassium
Watch out for: HYPERKALEMIA
MANAGEMENT

Non- Pharmacologic:

1. 02 Supplement (1-2 L per min via nasal cannula)

2. Position: Fowler’s (45-degree head elevation to promote chest

HEART FAILURE expansion)
Two types:
3. Low sodium, sugar, fat (NEED: high fiber and protein)
a. Right-sided Heart Failure - Vein congestion
S/SX: 4. IV: Heplock
1. JVD 5. Decrease oral fluid intake (800ml/day)
2. Edema (Anasarca)
6. Monitor: BP and VS, Weight, Intake and output, electrolytes,
3. Hepatomegaly (Liver enlargement) edema
4. Sphlenomegaly (Spleen enlargement)
Cardiomegaly
 Displaced PMI (point of maximal impulse)
b. Left-sided Heart Failure - Pulmonary
S/SX:
1. Dyspnea (Exertional - when pt. performs activity)
Notes only: Tachypnea (Rapid and shallow breathing)
(Hyperventilation- Rapid and deep breathing)

2. Fatigue