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© 2009 Delmar, Cengage Learning
Chapter 13
Heart
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Functions of theCirculatory System
• Heart is the pump that circulates blood
• Arteries, veins, and capillaries transport the blood
• Blood carries oxygen and nutrients to the cells and carries the waste products away
• Lymph system functions
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Major Blood Circuits
• Blood leaves the heart through arteries and returns by veins
• Blood circulation routes– General or system circulation
– Cardiopulmonary circulation
• Changes in the composition of circulating blood
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The Heart
• About the size of a closed fist
• Weighs about 1 pound
• Located in thoracic cavity; apex of heart lies on the diaphragm and points to the left of the body
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The Heart
• After 4 to 5 minutes without blood flow, the
brain cells are irreversibly damaged
• Can hear the heartbeat through the stethoscope
• Cardiac arrest
• Cardiopulmonary resuscitation (CPR)
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Structure of the Heart
• Hollow, muscular, double pump
• Pericardium and pericardial fluid
• Myocardium– Cardiac muscle tissue
• Endocardium
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Structure of the Heart
• Superior and inferior vena cava
• Coronary sinus
• Pulmonary artery
• Pulmonary veins
• Aorta
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Chambers and Valves
• Separated into right and left halves by septum; then each half separated into an upper and lower chamber
• Upper chambers– Left and right atria
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Chambers and Valves
• Low chambers– Left and right ventricles
• Valves keep blood flow going in one direction
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Valves
• Atrioventricular valves– Tricuspid valve
– Bicuspid or mitral valve
• Semilunar valves– Pulmonary semilunar valve
– Aortic semilunar valve
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Physiology of the Heart
• Double pump
• Right heart– Deoxygenated blood
• Left heart– Oxygenated blood
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Heart Rate and Cardiac Output
• Normal adult rate is between 72 and 80 beats per minute
• Stroke volume
• Calculating the cardiac output
• Exercise increases cardiac output
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Heart Sounds
• Valves make a sound when they close
• Called lubb dupp sounds
• Lubb– Tricuspid and bicuspid valves (S1)
• Dupp– Aortic and pulmonary valves (S2)
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Conduction System
• Electrical impulses cause rhythmic beating of heart
• Sinoatrial (SA) node or pacemaker
• Atrioventricular (AV) node
• Bundle of His
• Purkinje fibers
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ECG or EKG
• The electrocardiogram is a device to record the electrical activity of the heart
• Systole– Contraction
• Diastole– Relaxation
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ECG or EKG
• Positive and negative deflection
• P, QRS, and T waves
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Prevention of Heart Disease
• Heart disease is the leading cause of death– Coronary heart disease
• Risk factors
• Steps to lower risk or prevent heart disease
• Blood cholesterol levels and triglycerides
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Diagnostic Tests Noninvasive
• Angiography
• Cardiac MRI
• Coronary calcium scoring/heart scan
• Echocardiography
• Electrocardiogram
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Diagnostic Tests Noninvasive
• Exercise stress tests
• Holter monitor
• MUGA
• Transesophageal echocardiography
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Diagnostic Tests Invasive
• Cardiac catheterization
• IVUS (intravascular coronary ultrasound)
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Diagnostic Tests Blood Tests
• Arterial blood gases
• BNP
• Lipid panel
• Cardiac enzymes
• INR/Prothrombin time tests
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Animation – The Heart
Click Here to play
Heart animation
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Effects of Aging
• Heart muscle fibers replaced by fibrous tissue
• Heart valves increase in thickness
• Cardiac output decreases
• Changes become more significant when elderly person becomes physically or mentally stressed
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Diseases of the Heart –Common Symptoms
• Arrhythmia
• Bradycardia
• Tachycardia
• Murmurs
• Mitral valve prolapse
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Diseases of the Coronary Artery
• Coronary artery disease (CAD)
• Angina pectoris
• Myocardial infarction
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Infectious Diseases of the Heart
• Pericarditis
• Myocarditis
• Endocarditis
• Rheumatic heart disease
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Heart Failure
• When the ventricles of the heart are unable to contract effectively and blood pools in the heart
• Symptoms depend on which ventricle fails
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Heart Failure
• Left ventricle failure– Dyspnea
• Right ventricle failure– Engorgement of organs, edema and ascites
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Congestive Heart Failure
• Similar to heart failure plus edema of the lower extremities and blood backs up into the lungs
• Treatment
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Rhythm/Conduction Defects
• Heart block– First-degree block
– Second-degree block
– Third-degree block or complete heart block
• Premature contractions– PACs
– PVCs
• Fibrillation
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Types of Heart Surgery
• Angioplasty
• Coronary bypass
• Cardiac stents
• Transmyocardial laser revascularization
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Heart Transplants
• Used as last resort
• Histocompatibility
• Organ rejection
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Medical Highlights
• Pacemaker
• Cardiac resynchronization therapy
• Defibrillator
• Heart pumps