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 O XYGEN
• PULMONARY ARTERIES (R & L)
• OXYGENATED BLOOD TO HEART
• CORONARY ARTERIES (R & L)
• BUILDUP OF CHOLESTEROL FATS
• PLAQUE
"HARDENING OF THE ARTERIES”
• ATHEROSCLEROSIS

• Gender
• Age
• Heredity
RISK FACTORS OF CAD
• NO CONTROL
• 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&GT1=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