About the cardiovascular assessment in details

2. DEMONSTRATION
ON
CARDIOVASCULAR ASSESSMENT
PRESENTED BY-
MONU KUMAR YADAV
B.SC (N) 2ND YEAR
BHAARATH COLLEGE OF NURSING
CHENNAI -73

3. INTRODUCTIION
Cardiovascular system consists of heart and blood vessels
. The heart acts as a pump and the blood vessels are
channels carrying blood .
Cardiovascular assessment will help to identify significant
factors that can influence cardiovascular health such as
high blood cholesterol , smoking use , diabetes or
hypertension

4. CENTRAL VENOUS PRESSURE -
It is the venous pressure as measured at the right atrium done by
means of a catheter introduced through the median cubital vein to
the superior vena cava
BLOOD PRESSURE
Blood pressure is the amount of force ( pressure ) that blood flow on
the walls of the blood vessels as it passes through them

5. Systolic blood pressure
 systolic blood pressure (SBP) is the maximum pressure exerted
during ventricular systole.
It ranges between 100 to 140 mmhg
Diastolic blood pressure
Diastolic blood pressure (DBP ) is the minimum pressure during
ventricular diastole
It ranges from 60 to 90 mmhg with an average of 80 mmhg
It is the measure of peripheral resistance .

6. ANATOMY AND PHYSIOLOGY OF HEART
 The heart is covered by an outer fibrous pericardium and inner
serous pericardium.
 The space between two layers is termed the pericardial cavity
 The fluid present in the pericardial cavity ensure smooth movement
of the heart by acting as lubricant
 The human heart consist of four chambers , two atria and two
ventricles
 Two atria or two ventricles contract simultaneously as a single unit
 The two atria are separated by the interatrial septum
 Two ventricles are the separated by the interventricular septum
 The opening between the right atrium is guarded by the tricuspid
valve
 The opening between the left atrium and left ventricle is guarded by
the bicuspid valve

8.  The wall of the heart has three layers-
1 .epicardium
2. myocardium
3. endocardium
Epicardium –
 It is a serous layer covering the heart . It is the outer layer
of the heart
Myocardium –
 it is the middle layer of the heart .
 It is madeup of cardiac muscle cells which are involuntary
Endocardium –
 it is a single layer of endothelial cells lining the inner
surface of the heart

9. CONDUCTING SYSTEM OF THE HEART :-
This is special system is a combination of specialized excitable tissue
and pathway which are collectively termed the conducting system .
It is also known as junctional tissue
1. sinoatrial node ( SA node )
2. atrioventricular node ( av node )
3. bundle of hits
4. right and left bundle branches
5. purkinje fibers

11. ASSESSMENT –
HISTORY
The purpose of the cardiovascular health assessment is to provide
information about your cardiovascular symptoms and how they
developed. A complete cardiovascular history will give you
indications to potential or underlying cardiovascular illness or
diseases states
Past health history
• it is important to ask questions about your patients past health
history .
• The past health history should collect information related to the
cardiovascular system .

12. Lifestyle and psychosocial status –
• Nutrition
• Smoking
• Alcohol
• Exercise
• Drugs
• Family hiostry
Assessment article-
• Stethoscope
• Sphygmomanometer
• Pen light
• Pen
• Measure tap
• Wrist watch

13. Inspection –
Eye-
the presence of yellowish plaques of the eyelids could indicate hyper lipo
proteinemia a risk factor for hypertension
Chest-
• observe the chest for overall torso contour
• See pectus excavatum and pectus carinatum ( pigeon chest )
Skin-
• Clubbing-
the presence of clubbing indicates chronic poor oxygen perfusion to
the distal tissue of the hand and feet .

14. cyanosis—
The presence of cyanosis also denotes chronic poor oxygen
delivery to the peripheral tissue of the hands and feet.
Xanthomas—
the presence of yellow plaques under the skin excorialted
through the skin could indicate hyper lipo protein emia a risk
factor for hypertension.
Edema—
The presence of edema can be caused by several factor although
most commonly is associated with decreased cardiac function
leading to decreased capillary flow

15. Palpation –
use the palm of hand to feel the chest wall for the point
of maximal impulse (PMI) , which is usually found at the
apex of the heart . The apical pulse is generally located in
the 5th intercostal space about 7-9 cm to the left of the
midline .
Palpate the peripheral arteries include the branchial ,
radial, femoral , popliteal , dorsalis pedis and posterior
tibial . These should feel similar bilaterally

16. Chest percussion –
• Normally only the left border of heart can be detected by percussion .
• It extends from the sternum to mid clavicular line in the 3rd to 4th intercostal
space .
Ausculation-
• Ausculation is listening to the sounds of the body during a physical
examination .
• There are four heart sounds
S1 , S2 ,S3 and S4
 These sounds are produced due to the closure of valves or due to
turbulence to the flow of blood during different phages of the cardiac cycle .
 The heart sounds are produced due to vibrations set up by the closure of
valves and the vibrations of walls of the heart. blood vessel and column of
blood in the vessel .

17. The first sound ( S1 ) and second sound (S2) heart sounds are
heard by using the stethoscope
Abnormal sounds –
Heart murmurs are sounds such as whooshing or
swishing made by rapid , choppy , blood flow
through the heart . The sounds can be heard with a
device called stethoscope .
Heart murmurs can be present at birth or develop
later in life.

19. Symptoms –
• chest pain
• dizziness
• cough
• swollen liver
• fating
• blue or gray lips and fingers
• shortness of breath
laboratory tests-
 Blood tests
 Electrocardiogram ( ECG )
 Stress test
 Echocardiogram
 Chest x-ray
 Cardia MRI

20. Conclusion –
 Integrating the cardiovascular health history and physicial exam
takes practice. It is not enough to simply ask the right questions and
perform the physical exam .
 As the patients nurse you must critically analyze all of the data you
are obtaining.
Summary-
Till now we discussed about cardiovascular assessment , its define ,
central venous pressure , blood pressure, about heart and conducting
system of heart , assessment , article, inspection, palpation , percussion
,auscultation , abnormally sounds of the heart ,laboratory tests. Hope
you all under stood well

21. Journal abstract –
Artificial intelligence in cardiovascular prevention
Ciccarelli, Michele , gialluria
Published – may 2023
Abstract
Prevention and effective treatment of cardiovascular disease are progressive
issues that grow in tandem with the average age of the world population.
Over recent decades , the potential role of artificial intelligence in
cardiovascular medicine has been increasingly reconized because of the
incredible amount of real . World data regarding patient health status and
health care delivery that can be collected from a variety of sources wherein
patients information is routinely collected . Including patient registries ,
clinical case reports . Reimbursement claims and billing reports , medical
device and electric health like any other health data , RWD can be analyzed
in accordance with high quality research methods and its analysis can
deliver valuable patient centric insights complementing the information
obtained from conventional clinical trials.

22. Artificial intelligence application on RWD has the potential to
detect a patients health trajectory leading to personalized
medicine and tailored treatment this article reviews the
benefits of artificial intelligence in cardiovascular prevention
and management . Focusing on diagnostic and therapeutic
improvements without neglecting the limitations of this new
scientific approach.
Bibliography
d. Venkatesh, HH Sudhakar (2019) basics of medical physiology for nursing
students , Wolters Kluwer publication , page no 82-117