-
Heart location
Between 3rd and 6th intercostal space
-
why is the hearts location important
- palpate apical beat
- asculation
- IC injection
-
Why Must BP be maintained
- O2+Nurtition
- Removal of waste product
- transport of hormones
-
What is the blood flow through the heart
- Anterior Vena Cava
- Right Atrium
- Tricuspid valve
- Right Ventricle
- pulmonary valve
- pulmonary Artery
- LUNGS
- Pulmonary Vein
- Left Atrium
- Bicuspid valve
- left ventricle
- Aortic Valve
- Aorta
-
Cardiac Conduction Sustem
- 1. SA node
- 2. AV node
- 3. Bundle of HIS
- 4. Perkinje Fibers
-
Function of the SA node
sets rythmic activity of the heart by stimulationg contraction
-
AV Node function
transfers impulse from SA to the ventricals aloowing slight delay for complete filling of the ventricals
-
Bundle of HIS function
transfers impulse from AV node to bundle branches
-
Purkinji Fibers function
send impulase from branches to the myocardium
-
What is a ECG?
Recording of electrical activity in the heart
-
Patient Postintioning for ECG?
Right Lateral
-
Placement of Leads
- Right Axillary - White
- Right inguinal - Green
- Left Axillary - Black
- Left inguinal - Red
- Chest - Brown
-
PQRST Waves meanings
- P - Atrial Contraction
- QRS - Ventricular Contraction
- T - Ventricular Repolarization
-
What is an Arrhythmia?
- Disruption in normal activity in the heart
- abnormal in rate, rythem, or impulse origin
-
Steps in recognizing arrythmia
- 1. Evaluate R-R intervals
- 2. Determine if the impulses are sinus or not.
- a.Evaluate P waves
- b. Determine the relationship between P waves and QRS complexes
- c. Evaluate T waves
- 3. Look for anything unusual
-
Intrinsic Pacemaker rates
- SA Node 70-120 impulses per minute
- AV node 40-60
- Bundle of HIS 40-60
- bundle branches 20-40
- purkinji fibers 20-40
-
causes of Artifact
- Electrical interference
- Pt movement
- wandering baseline
- dried electrodes
-
Sinus Bradycardia
- Regular sinus rythem with slower rate
- Dogs <70bpm
- Cats <120Bpm
-
4 Ways to get heart rate
- Auscultate
- Pulse
- Palpate apex
- ECG
-
Murmur
Turbulent blood flow that creates extra heart sound
-
Systolic Murmurs
heard between S1 and S2 lubb (swoosh) dubb
-
Diastolic Murmurs
occurs after S2 dubb dubb (swoosh)
-
3 Most frequent causes of murmurs
- 1.Valvular insufficiency - Leaky Valves ( Tricuspid & Bicuspid / Aortic & Pulmonic)
- 2. Valvular Stenosis - Partially blocked valve (Aortic & Pulmonary, Right causes Ascites / Left causes pulmonary edema )
- 3. PDA - opening between aorta and pulmonary artery (Pulmonary edema)
-
Murmur grading
- I - quite & Local
- II-quite
- III-murmur can be heard immediatly
- IV-constant and loud, thrill can be felt
- V-constant with prominant thrill
- VI can hear w/o a stethoscope
-
Stroke Volume
colume of blood ejected from the heard during each beat
-
Cardiac output
Volume of blood ejected by the heart per minute
-
Preload
amount of pressure stretching the right ventricle after passive filling
-
Afterload
pressure the chamber generates to eject blood from the heart
-
3 ways heart compensates for decrease in cardiac output
- 1. Increase HR
- 2. myocardium Hypertrophy - muscle mass inc
- 3. Dilation of chambers - inc chamber size
-
Ascites
excess fluid in the space between the tissues lining the abdomen and abdominal organs (the peritoneal cavity).
-
Cachexia
Physical wasting with loss of weight and muscle mass
-
Orthopnea
The inability to breathe easily unless one is sitting up straight or standing erect
-
Heart Dz
abnormality in the heart; condition can lead to heart failure
C/S : tachycardic, lethergy, cardiac cough, tachypnea
-
Heart Failure
unable to maintain Cardiac output
C/S : pulmonary edema, pall MM, low BP, long CRT, orthopnea, cachexia
Due to ascites
-
Diagnostic Tests (7)
- 1. Ausculation - evaluates source of murmur
- 2. Echocardiogram - measure chambers & sounds
- 3. Doppler - let us hear artery, systolic BP 85-130mm hg
- 4. Oscillometric - diastolic BP
- 5.Blood Gas - O2 - % of oxigen saturated hemoglobin
- 6.Radiographs - size position
- 7.ECG - arrythmias
-
Systolic Blood presure measurement
80-130 mmhg
-
Congenital Heart Diseases (4)
- 1.PDA
- 2.Atrial Septal Defect (ASD) - hole allowing blood go from left to right / right to left
- 3. Ventricular Septal Defect (VSD)
- 4. Aortic or Pulmonic Stenosis (Pulmonary edema / Ascites)
-
Aquired Heart diseases (6)
- 1. AV insufficiency - caused by periodontal dz
- 2. Heartworm - right side of heart, right ventricle pulmonary valve (ascites)
- 3.Vegetative Endocarditis - bacteria settles on AV nodes
- 4. Hypertrophic cardiomyopathy - big muscle small chambers (maincoons)
- 5. Dilated cardiomyopathy - small muscle, large chambers Commonly related to feline taurine def.
- 6. Pericarditis/Cardiac Tamponade - caused by bac,virus,renal failure(muffled heart sounds)
-
Breeds predisposed to Dialated cardiomyopathy
- Great dane
- wolf hound
- cockers
- goldens
- gemans
- doberman pinchers
- boxers
-
CPCR
Cardiopulmonary cerebrovascular Resuscitation
-
CPA
Cardiopulmonary Arrest- sudden cessation of spontaneous and effective ventilation and systemic perfusion
-
Potential Causes of CPA
- *hypoxia
- *metabolidc disorders (addisons)
- *trauma
- *Anesthetic or other drugs
- *enviornmental influences
-
5 Signs of CPA
- 1. no palpable pulse
- 2.no auscultable heart beat
- 3. no ventilatory attempts
- 4. Discolored MM
- 5.dilated Pupils
-
How long does it take for cerebral injury from CPA to occur and why?
- 3-4 mins of arrest
- Changes in O2 Delivery to the brain
- Generation of toxins doue to Hypoxia
-
factors that affect CPA survival rate
- pre-arrest condition
- time elapsed since arrest
- cause of arrest
- inefective external cardial massage
- client wishes
-
3 phases of CPCR
- Basic life support-temporary
- Advanced life support-drugs and Dfib
- Prolonged life support- Past CPCR if Pt survives
-
Five tasks involved in CPCR
- 1 airway management
- 2 cardiovascular managemnt
- 3 venous access
- 4 Monitoring
- 5 Drug administration
-
Defibrillator
portable med. device that can be used to shack a heart back into rhythm; delivers a jolt of electricity that can shock the heart back into its proper rhythm
-
ABCD's of CPR
- Airway
- Breathing
- Circulation
- Drugs/Defib
-
Inotropes and Chronotropes
- I = Force of contraction - antiarrhythmias
- C = Heart Rate - Vasodilators
-
4 layers of heart
epicardium, myocardium, endocardium, pericardium
-
Quinidine
(Cardioquin, Quindex) - Atrial Fibulation, increases Conduction
-
Procainaminde
(Pronestryl, Procamide SR) - VPC's V Tach
-
Lidocaine
(Lidocaine, Xylocaine) - VPCs and V Tach
toxic in cats
-
Propranolol
(Inderal, Intensol) - Cat's VPC, Hypertrophic cardiomyopathy
-
Bretylium
- (Bretylol) Chem defib, V tach, V fib
- decreases HR
-
Amiodarone
(Cordarone) -tx vpc and vtach chemical defib.
-
Enalapril
(Enacarol) -congestive heart failure, hypertension
-
Hydralazme
(Apresoline) dec BR
-
Nitroglycerin
(Nitro-bid, Nitrol) - dec BP rapidly
-
Pimobendan
(Vetmedin) - tx CHF caused by DCM
-
Furosemide
(Lasix) - TX of pulmonary Edema
-
Hydrocodone
(Hycodan) - tx Cardiac Cough
-
Theophylline
(Thedair, Uniphyl) - Bronchodilalator, tx asthma used in conjuction w/ other in CHF and pulmonary Edema
-
Cardiac Glycosides
tx heart failure, Increase CO by increasing the force of conractions (+I)
-
Digoxin
- (Cardoxin, Lanoxin)
- Digitalis drug-tx of CHF and Afib (+I) (-C)
-
Catacholamines
- mimic CNS (+I) (+C)
- Increase BP by vasoconstriction
-
Epinephrine
Catacholamine tx: CPA
-
Dopamine
- (Dopram HCL, Inotropine)
- Catacholamine tx for actue heart failure, shock, oligura due to renal failure (Natural)
-
Dobutamine
- (Dobutrex)
- catecholamine
- synthetic tx for shock, increase BP (+I)
-
Isoproterenol
- (Isuprel)
- works as antiarrythmic, bronchoconstrictione
-
-
|
|