Understanding Heart Failure

Understanding Heart Failure
Understanding Heart Failure
Heart failure is a condition in which the heart muscle is unable to pump enough blood through the heart to meet the body's need for blood and oxygen.
Coronary artery disease is a form of heart disease that effects the chambers of the heart. There are four chambers in the heart. The upper chambers
consist of a right and a left atrium and the lower chamber consists of the right and left ventricles. The flow of oxygen rich blood travels from the lungs
to the left atrium and into the left ventricle where it is pumped into the rest of the body. When the heart functions properly, all four chambers beat and
pump blood effectively in an organized way. The Virtual Medical Centre (Centre, 2008) newsletter states that "Management,... Show more content on
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A cardiologist could be a primary medical provider to help diagnose heart failure. The test performed help the doctor diagnose the condition but also
the type of heart failure. The medical intake would include symptoms, chest exams to estimate the size of the heart, and lab tests to test thyroid and
kidney functions. The Cleveland Clinic (Clinic, 2009)to Heart Failure mentions "that the advance in medical technology medical providers have
tools to help them determine not only whether you have a heart failure but also pinpoint the cause and severity of the disease" With the advancement
in medical technology how can the condition treated? Treatment like the "diagnosis of heart failure" includes some various steps that a patient could
follow. Medications called diuretics, beta blockers, and digitalis glycosides are used to help treat heart failure. These medications help the heart by
getting rid of extra water and salt through the body and reduce blood pressure. For severe cases of heart failure, a patient may have to have a
pacemaker or for those worse cases a heart
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Animal Experimentation Essay
Every year, over a million animals are tested on across the world. Animal experimentation is one of the most controversial issues. Animal testing is the
use of non–human animals in research and development projects, especially for purposes of determining the safety of substances such as foods or
drugs. Some people believe that animal testing is unnecessary and there are more efficient alternatives. Others believe that animal testing is crucial to
the development of new products and cures. According to the Science of Toxicology, "Research involving laboratory animals is necessary to ensure and
enhance human and animal health and protection of the environment"(1). Animal testing should be stopped because animals do not react the same way
as ... Show more content on Helpwriting.net ...
One example of this is Thalidomide. The National Center for Biotechnology (NCBI), Thalidomide is one of the greatest cases in history of a drug
disaster tragedy caused by animal research. Thalidomide is a synthetic drug formerly used as a sedative and hypnotic but withdrawn from the market
when found to cause abnormalities in developing fetuses. It was was found to act as an effective tranquilizer and painkiller. Thalidomide was tested on
animals extensively prior to its marketing and was deemed safe for human use. Thalidomide is responsible for over 10,000 human birth deformities
(1–2).
Animal testing potentially prevents useful drugs from reaching the market. Penicillin is poisonous to Guinea Pigs (NPG 1). Penicillin is an antibiotic
with powerful bactericidal action, used to treat many types of infections, including pneumonia, gonorrhea, and infections caused by streptococci and
staphylococci. Penicillin causes fatal diarrhea and convulsions in guinea pigs (GuineaLynx 1). It is attributed to the toxins absorbed from the
intestines. Digitalis can kill dogs, but helps save humans. Digitalis is the dried leaves of the Digitalis purpurea plant that is used in medicine as a heart
stimulant. It is therefore often prescribed for patients in atrial fibrillation (Lindberg 1). Morphine is a stimulant for cats, goats, and horses but is a
sedative for humans.
Alternatives to animal testing are often more accurate. Cell culture is the

Verapamil Study
More than 100 years ago, Mackenzie noted the therapeutic effect of digitalis by slowing the heart rate in atrial fibrillation patients (1). Digoxin was
the cornerstone for atrial fibrillation until verapamil was discovered in1967; which shown to be effective in slowing the ventricular rate in atrial
fibrillation by Bender and colleagues (2). Klein and colleagues wrote a letter to the editor, in 1980, to report his experience with verapamil–digoxin
interaction to result in increased serum digoxin concentrations (SCD) by 58% (3). The first randomized study was published in The Lancet by Belz
and colleagues in 1981. (12). Verapamil co–administration with digoxin resulted in average of 77% increase in digoxin, which later the range was
between (5)(12). In 1981, Pedersen showed 34% reduction in total digoxin clearance and 23% reduction in digoxin volume of distribution induced by
verapamil (6). Hedman et al. proved that digoxin biliary is the main inhibitory mechanism for verapamil (25). Pedersen and colleagues found that...
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studied verapamil–digoxin interaction in cirrhotic patients. The study found 98% increase in the AUC and Cmax of digoxin and 23% decrease in
digoxin renal clearance. (21). Verapamil–digoxin interaction in chronic hemodialysis patients was studied in 1990. Rendtorff and colleagues study
showed great inter–individual variation in the influence of verapamil on SDC in chronic hemodialysis patients. (24). Two case reports of asystole, one
third degree AV block and two deaths for verapamil
–digoxin interaction. (15–18). Gordon, et al. published a case series in, 1986, suggested lower
digoxin doses for elderly and avoiding their concomitant use with verapamil. Finally, a case report in 2003 for Japanese male was found dead in his
room. The cause of death was documented as cardiac failure due to medications overdose. Kinoshita, et al. suggested that drug toxicity was potentiated
by verapamil–digoxin and metoprolol interactions.

Cardiac Dysrhythmias : Medical Careers
Eduardo Cardenas
Cardiac Dysrhythmias: Supraventricular Tachycardia
N254: Medical Surgical Nursing II
Mr. Decker
Medical Careers Institute
Date of Submission
1/7/2016
Cardiac Dysrhythmias: Supraventricular tachycardia
Supraventricular tachycardia is increase in heart rate over 150 bpm due to do the over firing or redirected firing of the SA Node conduction above the
ventricles. With supraventricular tachycardia the patient can have an abrupt onset and termination of rhythm, flattened or retrograde conduction P
waves and narrow QRS waves specifically less than 0.08 second (Kyle, 2012).
Clinical Manifestations and Pathophysiology The clinical manifestations of supraventricular tachycardia are palpitations, dizziness, ... Show more
content on Helpwriting.net ...
The nurse should also palpate pulses, noting rate, regularity, amplitude, and symmetry. This is done to differentiate in equality, rate, and regularity of
pulses that are indicative of the effect of altered cardiac output on systemic or peripheral circulation (Vera, 2013). Another nursing management is to
monitor vital signs. Assess adequacy of cardiac output and tissue perfusion, noting significant variations in BP/pulse rate equality, respirations, changes
in skin color, temperature, and level of consciousness. The rationale although not all dysrhythmias are life–threatening, immediate treatment may be
required to terminate dysrhythmia in the presence of alterations in cardiac output and tissue perfusion (Vera, 2013).
The nurse should also administer supplemental oxygen as indicated, Insert and maintain IV access, reduce patient stimulation, tell the patient to splash
cold water on their face, or to do a vagal movement to help decrease heart rate (Kyle, 2012). Adenosine (Adenocard) is the drug of choice of to treat
supraventricular tachycardia if vagal maneuvers have not worked due to its short half–life and minimal side effects. Other medications that can be used
to suppress supraventricular tachycardia can be

Vasodilator Therapy
The treatment options for NOMI are medical management and emergency surgery. If complications such as secondary peritonitis and sepsis co–exist,
the treatment plan should be tailored accordingly. Other existing complications and incidental findings for treatment regarding Mr. S.'s case will be
covered in this section.
Medical Management. Most cases of CI are resolved without surgical intervention in the absence of perforation or necrosis (Brandt et al., 2014, p.
36). Treatment starts with removing the possible cause of vasoconstriction or treating hypotension. To improve mesenteric perfusion, infusion of
vasodilators such as papaverine may be beneficial (Tilsed et al., 2016, p. 262). Vasodilator therapy is contraindicated if surgical intervention is
indicated, which will be discussed below. Papaverine is chosen over other vasodilator agents because studies found that it reduced mortality rates in the
setting of NOMI (Tilsed et al., 2016, p. 262). Drugs that may cause vasoconstriction or contradict include digitalis, kayexalate, NO–Xplode, and
nonsteroidal anti–inflammatory drugs (NSAIDs) (Brandt et al., 2014, p. 25). A ... Show more content on Helpwriting.net ...
Patients with a new ostomy need psychosocial support regardless of their background or culture. It is a change that affects an image. This patient needs
education and ostomy care training by wound, ostomy, and continence nurses' society (WOCN) certified nurse. Studies have shown that when patients
consult a WOCN–certified nurse, there is a reduction in complications and readmission (Hendren et al., 2015, p. 381). A WOCN–certified nurse is
consulted to educate Mr. S. Based on his needs, home health care will be considered upon discharge. Mr. S. also needs a follow–up appointment with
a general surgeon for reversal operations evaluation. Regarding the timing of ostomy reversal surgery, studies suggest it is safe to perform reversal
surgery as early as three weeks or later (Hendren et al., 2015, p.

Left-Sided Heart Failure Research Paper
Left–sided Heart Failure
Condition where the left side of the heart is unable to pump an adequate amount of blood to the body, and can be life–threatening.
Pathophysiology
With left–sided heart failure a patient can suffer from fluid in the lungs, shortness of breath and pulmonary edema, and fatigue. Since the heart can not
pump the adequate amount of blood to the rest of the body, there is a lack of oxygen in the body and this results in fatigue. Left–sided heart failure
causes an increase in pressure within the vessels in the lungs, which can lead to an accumulation of fluid within the lungs, which leads to shortness of
breath and pulmonary edema. There is a wide variety of causes of left–sided heart failure with include consuming too much alcohol, suffering from a
heart attack, infections of the heart muscle, increased blood pressure, hypothyroidism, narrow heart valves, and any disease that can cause damage to
the heart muscle. Left–sided heart failure in children is often caused by birth defects including abnormal ... Show more content on Helpwriting.net ...
Treatments include changes in your lifestyle such as reducing sodium, avoiding alcohol, and increasing exercise, taking medication for blood pressure,
and possible surgery or carried cauterization. Patients can also take medications such as beta–blockers, digitalis, diuretics, as well as others.
Beta–blockers can prevent death in some patients, digitalis slows the rhythm of the heart while increasing the patients heart beat, and diuretics will
reduce the amount of fluids retained in the body. In certain cases pacemakers can be recommended or if medications are unsuccessful on their own, a
patient may receive a heart pump. As a worst case scenario, a patient may require a heart

Heart Failure Research Paper
The following research paper details the medical and surgical treatment and nursing care of patients with heart failure and includes information specific
to left–sided heart failure.
Description of the Condition
Heart failure is a complex clinical syndrome in which the heart is unable to pump sufficient amounts of blood to meet the body's metabolic demands.
Specifically, the left side of the heart receives oxygen rich blood from the pulmonary veins and is responsible for systemic oxygenation by pumping
this blood through the aorta to the rest of body. The left ventricle provides most of the heart's pumping power; it has a thick muscular wall . When the
left ventricle weakens and becomes inefficient in its ability to.... the left side ... Show more content on Helpwriting.net ...
Digitalis and inotropic medications increase the force and contractility of the heart making each beat more efficient. Vasodilators, ACE inhibitors,
ARBs, and calcium channel blockers all work using different methods to lower blood pressure and vascular resistance easing the overall work load on
the heart. Please refer to Table 1 for a comprehensive list of common medications used for treatment of LSHF.
The most important nursing intervention with any medication is monitoring vital signs and trends especially blood pressure, pulse, and condition
before administering cardiac medications such as ACE inhibitors, ARBs, digoxin, and beta blockers. These medications often come with set parameters
set by the physician and is specific to the patient. It is also critical that the nurse evaluate how well the patient is tolerating the current medication
regime and to never withhold a medication without the physician's input with justification (Ackley & Ladwig, 2014).
Complications and

Creativity And The Mad Genius
Creativity and the Mad Genius On July 2, 1961, Ernest Hemingway put a gun to his head. Seventy–one years earlier, on July 29, 1890, Vincent van
Gogh shot himself in the abdomen while painting a wheat field. Robin Williams hung himself on August 24, 2014, less than two centuries after
Vincent van Gogh. Along with Ludwig von Beethoven, who died of natural causes in 1827, four of the greatest creative minds each suffered from
bipolar disorder, depression, or epilepsy, usually suffering from other physical ailments as well. Ernest Hemingway was the only one to seem to have
a genetic disposition towards mental illness. None of these men led similar lives. Van Gogh only saw one of his paintings sold, while Beethoven was
an acclaimed composer by the age of twenty–nine. Hemingway was friends with some of the greatest literary minds of the day, and Robin Williams
was one of the most successful comedians to date. The common link, besides their mental illnesses, is the idea that each of these men were searching
for something more within their respective arts. Four fields of fine arts that require the constant creation of something new claimed the lives of four
men who gave it all they had, some losing, and some finding themselves along the way. Over the past sixty years, facts about depression and the reality
of it have come to light; however, there are still negative stigmas concerning the mental illness and how people ought to endure through the pain.
Despite these negative

Heart Disease: Peripartum Cardiomyopathy
Peripartum Cardiomyopathy
A lot of people in this world are unknown to the heart disease called peripartum cardiomyopathy. This heart disease is a uncommon heart disease. It's a
heart failure that happens in some women in the last month of their pregnancy. With this heart disease the heart cannot pump enough blood to the
body's vital organs. Which then causes organ failure if not caught. PPCM is still being studied doctors still don't know what exactly triggers the heart
failure. They say it may be from autoimmunity, immune system micronutrient. In the beginning phase of PPCM it causes inflammation in the heart.
The heart muscle cells start to become damaged. After the heart muscle is damaged scar tissue begins to form. Which makes it hard... Show more
There are several medications that the doctor can prescribe to you for PPCM. It depends on how sever the condition is. A heart can still live for a
long time with damage. If it is beyond damaged patient will be put on heart transplant list. In some cases, doctors may implant a heart balloon heart
pump. The medication taken are beta blockers, digitalis, and diuretics. Low salt diet may be needed to manage blood pressure. Beta blockers are used
to cause the heart to beat more slowly to help the heart to recover in time. The beta blockers may cause dizziness, weakness, fatigue, dry mouth,
headache, diarrhea, and constipation in some cases. Digitalis side effects are nausea, vomiting, feeling weak, headache, anxiety, and mild skin rash.
Diuretics most common effects are too little potassium in the blood, low sodium level, headache, thirst, increased blood sugar, and muscle

Cor Pulmonale: A Case Study
"Cor pulmonale is defined as an alteration in the structure and function of the right ventricle caused by a primary disorder of the respiratory system"
(Sovari, 2014). Right–sided heart failure usually occurs when pulmonary arterial pressure equals systemic blood pressure; pulmonary hypertension that
contributes to the enlargement (hypertrophy, dilation, or both) of the right ventricle (McCance, 2010).
It is estimated that in the US alone, cor pulmonale accounts for 6–7% of all types of adult heart disease in addition to 10–30% of decompensated heart
failure–related admissions. The incidence of cor pulmonale varies globally depending on the prevalence of risk factors for various lung diseases
including but not limited to cigarette smoking ... Show more content on Helpwriting.net ...
On percussion, hyperresonance of the lungs may be a sign of underlying COPD; ascites can be seen in severe disease. Examination of the lower
extremities reveals evidence of pitting edema which is strongly associated with hypercapnia. Complications of cor pulmonale include syncope, hypoxia,
pedal edema, passive hepatic congestion, and death (Sovari, 2014) (McCance, 2010).
Diagnosis
Diagnosis of cor pulmonale starts with a generalized approach consisting of routine laboratory tests, chest radiography, and electrocardiography. While
high–resolution echocardiography and magnetic resonance imaging are accurate methods to measure pulmonary pressure; right heart catheterization is
considered the most precise albeit invasive method for diagnosis (Sovari, 2014).
The following modalities are also used as needed:
Pulmonary function tests
Ventilation/perfusion (V/Q)

Effect Of Exercise On Cardiovascular Dynamics
PhysioEx 9.1 Cardiovascular Dynamics Ex. 5 Activities 5 and 6 (3.5 points)
Activity
Question
Answer
#5. Studying the Effect of Blood Vessel Radius on Pump Activity
Explain the effect of increasing the right flow tube radius on the flow rate, resistance, and pump rate.
Increasing the right flow tube radius increased the flow rate, decreased the resistance and increased the pump rate.
Describe what the left and right beakers in the experiment correspond to in the human heart
The left beaker corresponded to the blood coming from the lungs, and the right beaker corresponded to blood heading out to the rest of the body, or
systemic circuit.
Briefly describe how the human heart could compensate for flow rate changes to maintain blood pressure.
The human heart could compensate for flow rate changes to maintain blood pressure by altering heart rate. When the heart rate increases, so does
blood pressure. When the heart rate decreases, so does blood pressure.
#6. Studying the Effect of Stroke Volume on Pump Activity
Describe the Frank–Starling law in the heart
The Frank–Starling law states that when all other factors remain the same, that the stroke volume will increase in response to how much the muscle is
stretched in the end diastolic volume.
Explain what happened to the pump rate when you increased the stroke volume. Why do you think this occurred? How well did the results compare
with your prediction?
When the stroke volume was increased, the pump rate decreased

Heart Failure Research Paper
Victor Hulsey
Course Professor: Jason Valdez
EMSP 2544: Cardiology
03 August 2014
Treatment of Heart Failure
Abstract: With the numerous discoveries and advances in pharmaceuticals and mechanical implantation devices, heart failure continues to be the
leading cause of hospitalization in patients over the age of 65 in the United States and other developed countries. Advances in science and modern
medicine have pushed heart failure to the forefront of an emerging crisis in developed countries around the world. The increase in heart failure cases
appears to be directly related to the increasing average age within these countries. Richard E. Klabunde's PhD, research estimates that there are "more
than 15 million new cases of heart failure each ... Show more content on Helpwriting.net ...
With the advancement microchip technology, many of modern day treatments are including cardiac assist devices to supplement the pharmacological
treatments. Although these treatments can be more invasive and the overall prognosis remains poor, these treatments have been shown to increase
ones expected life span an average of ~8.5 years.
Despite many new advances in patient care, drug therapy and cardiac assist devices, the prognosis for chronic heart failure remains very poor. One
year mortality figures are 50–60% for patients diagnosed with severe heart failure, 15–30% in mild to moderate failure, and about 10% in mild or
asymptomatic failure. With gene therapies, and cell implantation/regeneration just on the horizon, the prognosis for heart failure patients is much more
promising than just 20 years ago.
Researchers at the Cardiovascular Research Center at Icahn School of Medicine have successfully tested a powerful gene therapy known as
"SUMO–1" that is delivered directly into the myocardium to reverse heart failure in large animal models. Although this treatment has yet to be proven
in human clinical trials, it may be one of the first treatments that can actually shrink hypertrophied myocardium tissue; thereby significantly improving
the damaged heart's life–sustaining function.

What Really Happened To Martin Pugh?
With Dennis on his right and Jenn on his left they managed to get Marty out of the restaurant. The chauffeur guided him into the back seat and
Jenn slid in next to him. Once the door was closed she buckled him in. She didn't strap herself in. She would need every advantage once the drug
took full effect. A calm swept over her. It was done. The life of this vicious killer had finally come to an end, and he was completely unaware.
Whatever happened next was gravy as far as she was concerned. The drive to her own apartment seemed endless, but knowing it was the last time
she'd have to lay eyes Martin Pugh made it that much sweeter. When the car halted outside her building, she gave an inward sigh of relief. "I'd kiss
you good night but I don't... Show more content on Helpwriting.net ...
She had had to rent apartment and get a real job or Marty's suspicions would have been raised. The one room studio she found on the edge of the
University of Washington campus on Brooklyn Avenue North East was the answer. It gave off the just the right desperate, broke, bookish vibe.
Campus was two blocks away. It was an easy walk to the bus, restaurants, or campus The perfect cover was barista with modeling aspirations. Seattle
was full of them. This time she was on her own. Jenn couldn't use any of the safe houses or other resources Langley made available to their agents. No
back –up, and no extraction squad. She had to be on guard at all times and couldn't trust anyone. Who would they send to track her? Would they find
her and have a sharpshooter take her out? That was the one scenario she couldn't prepare for. She would never see it coming. With any luck Bobby
Pugh and his personal army wouldn't locate her either, but the chances of her survival were slim to none. No matter how she sliced it her days were
numbered, and if they were going to take her down she wasn't going down without a

Vincent Van Gogh's Accomplishments
Abstract
Early childhood, failed career paths and art as a profession.
Vincent van Gogh was born in a small village in Holland on March 30, 1853. This date is significant as van Gogh's dead brother was born exactly
one year before him. His parents could not deal with the trauma of losing their first son, as a result this left a lasting impression on the second
Vincent. Van Gogh's older sister, described his adolescence as "intensely serious and uncommunicative...he was a stranger to himself" (Butterfield,
1998). The artist himself was aware of his own deviating behavior, in a letter he wrote to his brother, he expresses: "my youth was gloomy, cold and
sterile" (Butterfield, 1998). During the later part of his life van Gogh's paintings exhibited a common theme of yellow hues ; he was personally
concerned with his self–image; and increasingly became dependent on foxplate flowers as a means of treating the epileptic seizures. During the last
two years of his life, Vincent is taken in and out of asylums and receives treatment with little success. He suffers from several more psychotic episodes
and ultimately commits suicide.
Vincent van Gogh's is known for his imaginative and creative paintings, which speak volumes about his talent and mental illness. Although there are
many hypotheses ... Show more content on Helpwriting.net ...
In of his letters to Theo, he states: "and without your friendship I would be driven to suicide...I would finally do it" (Blumer, 2002). The dependent
state can be a result from van Gogh's unstable interpersonal relationship with parents. His relationship with his mother was one that lacked an
emotional connection, because she experienced trauma after losing her first son (Blum, 2009). In contrast, the relationship between van Gogh and his
father was tense, since he rejected calvinism and a career as a minister (Blum, 2009). Thus, Vincent fulfills this symptom for borderline personality

Creative Project: Inspired To Paint Analysis
Creative Project: Inspired to Paint When I began my project, I envisioned myself using oil paint on canvas. I've always admired oil paintings, when
the paint is thickly applied and layered. I researched my artists and learned about their techniques. It seemed easy enough, and I felt confident to give
it a try. Unfortunately, things did not work out like I planned, and I found that I have a lot to learn. Van Gogh layered his paint with short thin brush
strokes using different colors in Starry Night. I learned that the colors must set before you can layer them, so the colors do not smudge together. Also,
during my research I found out that Monet would only paint for one hour at a time, and now I understand why. I found myself getting frustrated

A Brief Note On Pharmacology And The Nursing Process
Digoxin
Oluchi Madubuike
University of Texas at Arlington
Pharmacology and the Nursing Process
N3365–001
Sandra Laird
April 1, 2015 OVERVIEW OF DIGOXIN
Origin
Digoxin is a drug gotten from the leaves of a digitalis plant ("Digitalis," 2015, para. 1). We commonly refer to this plant as foxglove but we also use
its botanical name, which is Digitalis purpurea when discussing it ("Digitalis," 2015, para. 2). Foxglove is a popular flower that can be found
growing along the roadsides and in meadows or waterlogged areas usually in the western region of the United States ("Digitalis," 2015, para. 2).
Although this plant can now be found in America, European immigrants originally brought Foxglove into the United States centuries ago ("Digitalis,"
2015, para. 2). William Withering first described the therapeutic effect of this plant in 1785 ("Digitalis," 2015, para. 4).
Drug Class
Digoxin is grouped under a class of drugs known as cardiac glycosides (Lilley, Collins, & Snyder, 2014, p. 387). Cardiac Glycosides are a class of
drugs known as cardiac drugs (Lilley, Collins, & Snyder, 2014, p. 387). They are the oldest group of cardiac drugs that are recognized to have
beneficial effects on people with failing heart and help in controlling the heart's ventricular rate (Lilley, Collins, & Snyder, 2014, p. 387). These drugs
help make the heart beat stronger and with a more regular rhythm. In previous years, cardiac glycosides (digoxin) were used as the first line drugs for
heart

Tissue Transplantation Paper
transplantation is done at an advanced stage when cardiac function is unresponsive to medical, or surgical interventions (Grossman & Porth, 2014).
The loop diuretic Lasix can be prescribed to Mr. S.K. for his lower extremity edema along with a potassium supplementation (diuretic cause further
potassium loss through urine) and captopril can be prescribed for his hypertension. The beta blocker can also be added to the treatment plan for Mr.
S.K. to reduce the cardiac workload. Health education is provided to S.K. about the importance of sodium and fluid retention and the importance of
weight management is also emphasized. Oxygen is delivered through an oxymask for S.K. to maintain a saturation above 92% on room air.
Drug Related Issues
There are numerous contraindications ... Show more content on Helpwriting.net ...
The drug phosphodiesterase inhibitors are contraindicated in the presence of allergy to these drugs, to prevent hypersensitivity reactions. These drugs
are also contraindicated in severe aortic or pulmonic valvular disease, acute MI, fluid volume deficit, and ventricular arrhythmias (Karch, 2013). This
drug should be used with caution in elderly and during pregnancy and lactation. The adverse effects with phosphodiesterase inhibitors include
ventricular arrhythmias, hypotension, and chest pain (Karch, 2013). GI effects include nausea, vomiting, anorexia, and abdominal pain.
Thrombocytoenia is another adverse effect seen with milirone and inamrinone. The hypersensitivity reactions with these drug include vasculitis,
pericarditis, pleuritis, and ascites (Karch, 2013). These drugs should not be combined as solutions with furosemide because this will form precipitates.
Burning at the intravenous injection site is also a frequent side effect. ACE inhibitors are contraindicated in the presence of allergy to prevent
hypersensitivity reactions and with impaired renal function (Karch,

Cardiac Physiology
Module 5 CARDIAC PHYSIOLOGY Case No. 1 Melvin Rodriguez was admitted at the intensive care unit. On the first hospital day, he developed
hypotension, BP of 70/40, cardiac rate of 100 beats per minute, rales all over lung fields, respiratory rate of 24 breaths per minute. Pertinent physical
examination showed patient was dyspneic, distented neck vein. Patient was on left ventricular failure with pulmonary congestion. Questions 1. What is
the Frank starling law of the heart? The Frank–Starling law of the heart (also known as Starling's law or the Frank–Starling mechanism or Maestrini
heart's law) states that the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end... Show more
Digoxin enhances myocardial inotropism and automaticity but slows impulse propagation through the conduction tissues. Digitalis reciprocally
facilitates calcium entry into the myocardial cell by blocking the Na K adenosine triphosphatase pump. This calcium influx may account for its positive
inotropic action because this inotropic response is not catecholamine– or beta receptor– dependent and is therefore effective in patients taking
beta–blocking drugs. Digitalis was expected to increase contractility and return the Frank–Starling relationship toward that seen in a normal ventricle. 5.
Why was he sent home on a low sodium diet? Sodium is usually limited to prevent fluid accumulation. A low sodium diet was recommended to
reduce extracellular fluid volume and blood volume, and to prevent subsequent episodes of pulmonary edema. Case No. 3 Theresa Camantiles was a
38 year old home maker and mother of 4 children. Keeping house and driving the children to activities kept her busy. To stay in the shape, she took
aerobics classes at the local community center. The first sign that Theresa was ill was vague; she fatigued easily. However, within 6 months, Theresa
was short of breath, both at rest and when she exercised, and she had swelling in her legs and feet. She then sought medical consult. On physical
examination, she had distended jugular vein, liver was enlarged and had ascites in her peritoneal cavity and edema in her legs. A fourth

Cor Pulmonale Research Paper
Cor pulmonale is a condition associated with diseases of the lung (e.g., COPD, fibrosis, etc.), where either the altered structure or the malfunction of
the right ventricle arises from pulmonary hypertension. In COPD patients, hypoxic vasoconstriction results in increased pulmonary artery pressure,
which causes hypertrophy of the right ventricle and lowers cardiac output. Overall, cor pulmonale is a chronic condition with a slow onset, despite
acute presentations of the condition due to a failure of the right heart to adapt to an increase in pulmonary arterial pressure due to a pulmonary
embolism. The clinical manifestations of cor pulmonale typically include dyspnea on excretion, anorexia, exertional angina and syncope, and fatigue.
Treatment ... Show more content on Helpwriting.net ...
Digitalis also decreases the sympathetic response by lowering circulating norepinephrine, which is a strong predictive of mortality in heart disease.
Evaluating the effects of digitalis in patients with cor pulmonale is difficult because the respiratory component of their disease primarily controls the
outcome. However, Digitalis has been found to be effective in specific subpopulations of cor

Who Is Vincent Van Gogh's Wheatfield With Crows?
Van Gogh's Wheatfield with Crows: Scholarly Article Analysis
The Impressionist and Post–Impressionist eras have produced many great painters that are still relevant to this day. Among these painters is Vincent
Van Gogh, who created hundreds of paintings in a span of a short ten–year career. The three articles by Friedman, Schapiro and Bhattacharyya all
analyze Van Gogh's Wheatfield with Crows based on the artist's physical and mental state, but differ in their approaches (Fig. 1). The painting
Wheatfield with Crows is a great example of the style that Vincent Van Goghis knows for. The short, seemingly carefree brush strokes form the sky,
the field and the three roads. The black crows add movement to the scene and provide ground for future disagreements among scholars. The colors in
the painting are very vibrant, with a strong contrast between the dark stormy sky and bright yellow fields. ... Show more content on Helpwriting.net ...
Some even think that it was Van Gogh's last painting. Such claim, if true, tremendously elevates the importance of the painting. It would no longer be
looked at as "one of Van Gogh paintings" but as a painting that could provide insight into what Van Gogh felt in the last days before his suicide.
Though it most definitely would be an important finding, it would also cause the painting to be analyzed only through the lens of Van Gogh's physical
and mental state. Such constrictions significantly limit the analysis. Therefore it is better to look at Wheatfield with Crows as "one of Van Gogh's last

A Case Study In Polypharmacy
A Case Study in Polypharmacy
The case study of Mrs. A has numerous factors that constituted in her health problems and manifestations. In her symptomatic scenario, the patient has
been presenting some indications comprising of irritability, ostensible obsessive–compulsive behavior, confusion, and fatigue. The patient's daughter is
anxious about her mother's ability to stay independent and wishes to pursue nursing home admission arrangements and the fear that her mother might
progress to dementia illness. On the other hand, based on her prescribed medications, several conclusions can be observed.
Congestive cardiac failure (CCF) is a clinical syndrome where the heart is no longer able to maintain adequate blood circulation to the tissue; and the
indications are dyspnea, fatigue, and physical weakness (Barremo, Bruce, Salander & Sundin, 2008). Osteoarthritis is the greatest communal form of
the degenerative joint disease and the prominent cause of disability in people over 50 years of age and ... Show more content on Helpwriting.net ...
The vital nursing implementation and considerations are to assess the baseline data, such as the heart rate and rhythm, blood pressure, and electrolytes
prior to administering the initial dose. The dosage is regulated by the patient's clinical situation and can monitor by means of serum levels of cardiac
glycoside, calcium, potassium, magnesium, and through ECG. Digoxin has been a suitable aide treatment to improve signs and symptoms of heart
failure, the under dosage of digoxin will cause a continuation of heart failure symptoms, while overdosage may result in toxicity; in cases of severe
digitalis toxicity, digoxin immune Fab can be given intravenously to patients (Faye Felicilda–Reynaldo,

The Death Of Heart Failure
Based on Goodman and Fuller (2015), it was estimated that the annual population in the United States with (CHF) congestive heart failure is about
five hundred fifty thousand, and approximately five million male and female elderly individual (65 years old and above) is the leading cause of
hospital admission. Moreover, heart failure has a significant twenty percent of an estimated death rate and fifteen percent survival rate of patients
diagnosed with CHF (Bocchi, Vilas–Boas, Perrone, CaamaГ±o, Clausell, Moreira et al., 2005; Hunt, Abraham, Chin, Feldman, Francis, Ganiats et al.,
2005).
CHF renders the heart to become inefficient pump. As a result, the patients develop a decline with blood pressure, reduced cardiac output and blood ...
Furthermore, digitalis is also beneficial for patients with atrial fibrillation and with systolic CHF, it promotes to function the left ventricle and controls
the heart rate with low ejection fraction ( Caccamo & Eckman, 2011; Katzung, 2012).
Pharmacodynamics/ mechanism of action of DG Digoxin and numerous substance of digoxin are the only active metabolite in a small fraction that
occurs in the stomach, liver, as well as their metabolic passageway has been recognize (Gault, Longerich, Dawe, M., & Fine, 1994). DG and other
glycosides drugs for the heart help to elevate an involuntary action by producing more intracellular calcium absorption (Ciccone, 2016).
The intensity and immediate contraction of the myocardium are high due to the result of the inhibiting activity of the sodium and potassium ions
opposite to the myocardial nucleic cells by the intricacy with the (ATP) adenosine triphosphate; the improvement of the calcium flow and increase
elimination of the free ionic calcium inside the cells of the myocardium thus, automatically heightened the contractility of myocardial function
(Drugs.com., n.d.) . There is a reduced amount of conductivity and higher effectivity of the temporary response to the time period of the (AV)
atriventricular node which is significant to the secondary response from the conduction of the parasympathetic strength and probably from a decline in
sympathetic strength (Goldsmith, Simon & Miller, 1992;

Coronary Heart Failure Research Paper
"His heart is over flooded...." used to be the term for fluid overload or congestion associated to ailment of the heart. It is one of the phrases with
which congestive coronary heart failure (CHF) was described in the Ebers papyrus written in 1550 BC, at some point of the reign of Amenhotep
III, Pharaoh of the Eighteenth Dynasty, according to Saba et al.6 In a assessment of coronary heart failure (HF) by means of Katz,7 he describes
the Hippocratic Corpus, which describes rales already in the 4th century BC. Then Katz takes us through the history of HF with the aid of Galen
who lived in the Roman Empire, who noticed the coronary heart distributing warmness in an ebb and flow. This was believed till 1628 when William
Harvey described the circulation in animals as, "pulsatile movement", and created the groundwork for understanding the circulation. The use of
Foxglove (Digitalis purpurea) was once described via William Withering, an English physician and botanist. He had discovered from a country woman
that tea made from leaves of the foxglove used to be top for dropsy.... Show more content on Helpwriting.net ...
In the 1980s and early 1990s, it was once verified that angiotensin –converting–enzyme inhibitor (ACEi) have been associated with enchancment in the
clinical effects for HF patients. Then followed the introduction of the present day HF treatments; beta blocker, angiotensin receptor blockade,
mineralocorticoid receptor antagonist, Cardiac Resynchronisation Therapy (CRT), with or without defibrillation therapy, left ventricular aid device and
heart transplantation. Regarding the diagnostic possibilities, echocardiography has emerged as an vital device to consider HF patients, alongside with
natriuretic peptides (NP). Despite this enchancment in HF medication, the mortality charge is high. Can tailored HF remedy with the assist of
biochemical measures such as NP lead to a higher consequence for HF

Blood Of Plasma And Formed Elements
Conclusion:–
Blood consists of plasma and formed elements. Erythrocytes transport mainly oxygen to all body tissues. Leukocytes protect the body against
pathogens by direct attack or by forming antibodies. Platelets play an important role in blood clot formation. The heart is divided into four chambers.
It acts as a double pump system. The pulmonary circuit, which provides for gas exchange, is served by the right atrium and right ventricle of the heart.
The systematic circuit, which supplies blood to all body tissues, is served by the left atrium and left ventricle of the heart. For each heartbeat, the P
wave indicates the atrial depolarization, the QRS complex reflects the ventricular depolarization, and the T wave reflects the ... Show more content on
Helpwriting.net ...
Discussion:–
Lab 4: blood consists of two major components: plasma, which is 90% water and nonliving fluid matrix, and formed elements, which are living cells
suspended in the plasma. Erythrocytes, Leukocytes, and platelets are the three types of the formed elements. Erythrocytes, or red blood cells, contains
hemoglobin molecules and plays an important role in oxygen (and small amount of carbon dioxide) transportation. Leukocytes, or white blood cells,
helps defending the body and are part of the immune system; there are five types of Leukocytes: neutrophils, eosinophils, basophils, lymphocytes, and
monocytes. Each type has a unique function in defending the body against any pathogens. Neutrophils are the most abundant, monocytes are the
largest, lymphocytes are the smallest, and basophils are the least abundant leukocytes. Platelets play an important role in blood clot formation. The
heart consists of four chambers: right atrium, right ventricle, left atrium, and left ventricle. The heart acts as a double pump. The pulmonary circuit is
served by the right atrium and ventricle, they pump the deoxygenated blood, coming from all body tissues through the superior vena cava and inferior
vena cava, to the lungs to unload carbon dioxide and upload oxygen, and then enter the left atrium of the heart. The main function of the pulmonary
circulation is to allow for gas exchange. The systematic circulation carries the oxygenated blood from the left side of the heart and pump

Consuelma's Dilemma Case Study Summary
(A)Describe the problems Consuela and the client's family are having dealing with this situation
–Consuela is not communicating effectively with Allie.
–Consuela is not considering Allie's feelings about transitioning.
–The family and Allie are not collaborating effectively to facilitate care.
–The staff is not setting boundaries with the client.
–The relationship could be unhealthy, due to the client's current mental status.
(B) Discuss how it would be best to handle this, including the best outcome for the client. The best outcome for the client is to focus on her own needs
and not get deeply involved in a relationship. The case manager should be providing support, appreciative responses, building trust, inviting
collaboration, and providing positive feedback for the client. The case manager can ask the client what she thinks about leaving the home. If ultimately
agreed upon, the case manager can provide resources to complete a transfer. In addition, the case manager can implement a plan for intervention that
consists of family therapy. A case manager should be a reflective listener and try to their... Show more content on Helpwriting.net ...
There can definitely be an issue with this patient being seen by several physicians. In this case, I would assume no one had the time to accurately
collaborate on the best treatment for the client. The new physician the patient is seeing probably is missing out on essential information about the
patient's health history and background. Gui's over–the–counter medications could be counteracting with his heart medications. I would recommend
Gui needs go to necessary follow–ups, so his symptoms can be addressed and possible side effects can be monitored carefully. As a case manger, I
would only speak with the son on these issues after my client had signed a release and consented to me discussing this information. I would refer the
client to a health care provider and follow–up on his regular

Clinical Trials And Observational Studies
The efficacy of ACE–I has been widely evaluated in clinical trials and observational studies. In 1983, Captopril multicenter research group
investigated the efficacy of Captopril in a 92 cohort with heart failure refractory to digitalis and diuretic therapy. In this randomized, double blind trial,
50 patients were assigned to Captopril and 42 were assigned to placebo group. Over 2–week dosage titration and 10–week evaluation period, the
Captopril group revealed improvement in exercise tolerance and specific symptoms of heart failure, including dyspnea, fatigue and orthopnea, and the
reduction of edema. Captopril therapy were concluded as an effect adjunctive treatment to digitalis and diuretic drugs for patients with refractory heart
failure. (14) Later on, other ACE–I, such as Enalapril, were shown to be effective in treating patients with congestive heart failure, by reducing left
ventricular dimension, in randomized clinical studies.(15–17) The Heart Outcomes Prevention Evaluation Study Investigators conducted a factorial
study to evaluate the ACE–I, Ramipril, for improving outcomes among patients with high risk for cardiovascular events, but without left ventricular
dysfunction or heart failure. Ramipril significantly reduced the rates of death, myocardial infarction, and stroke in a broad range of high–risk patients
who are not known to have heart failure. (18) Cattran et al. performed a registry study in Toronto Glomerulonephritis in patients with severe
immunoglobulin

Fast Or Abnormal Heart Disease: Tachycardia
Tachycardia may be defined as the increased heart rate than normal. Fast or abnormal heart rate may be caused due to several reasons. For example
increased blood pressure, heart disease (like atherosclerosis, cardiomyopathy, valve disease) and some drugs (i.e. caffeine, alcohol) can increase blood
pressure. Tachycardia may cause no symptoms or complications for some cases but it can disrupt cardiac function, increase the risk of stroke or heart
attack1.
Treatment options:
Primary target of the treatment is to control the heart rate or remove the disease contributing factor. Digitalis alkaloids, ОІ–blockers (i.e. propranolol,
atenolol, metoprolol etc.), calcium channel blockers (i.e. amlodipine, nifedipine etc.) or amiodarone could be used to

Fusion Constipation Research Paper
Introduction This is a review of Fusion Health Constipation tablets, which are presented by the manufacturer as a vegetarian/vegan combination of
Chinese herbs which have been used for thousands of years to relieve the unpleasant symptoms of constipation and stimulate healthy bowel function.
Read on to discover more about this laxative to decide if this is a product that will work for you. Ingredients Rheum officinale (Rhubarb root)
7.5mgTrichosanthes kirilowii seed (Chinese cucumber) 500mg Rehmannia glutinosa(Foxglove root, otherwise known as Digitalis) 500mg Citrus
aurantium (Bitter Orange root) 400mg Angelica polymorpha (Dong Quai fruit) 400mg Glycyrrhiza uralensis (Licorice root)250mg Dosage
Recommended, adult dosage is one to two tablets, one to two times daily, following meals and water. An additional dose may be ingested to accelerate
a bowel movement and as directed by your physician. It is not recommended for children younger than 12 years of age.... Show more content on
Helpwriting.net ...
If you are experiencing gastrointestinal upset or abdominal pain, vomiting or diarrhea do not use this medication and contact your physician as these
symptoms may be indicative of a serious problem. Also, continued use may cause serious complications and bowel

Congestive Heart Failure Research Paper
Abnormal heart rhythms, infections in the valves of the heart, and congenital heart disease are other heart problems that can lead to congestive heart
failure.
Some symptoms of heart failure are weight gain, swollen feet and ankles, fast or irregular pulse, palpitations, fatigue, weakness, loss of appetite,
faintness, nocturia, shortness of breath especially during physical activities or while at rest, enlarged abdomen and liver.
To diagnose congestive heart failure, the healthcare provider will examine the patient for edema, distended neck, crackles, difficulty with breathing or
breathing that is fast, and abnormal heart sounds.
An echocardiogram and numerous blood test may also be used to identify congestive heart failure.
Self– care and

Atrial Fibrillation: A Case Study
It's known that atrial fibrillation (AF) is the most common sustained cardiac arrhythmia representing abnormal rapid and irregular ventricular rates with
deterioration of atrial mechanical function resulted by disorganized atrial electrical activity classified as acute, chronic, paroxysmal, intermittent,
constant, persistent, or permanent and when a patient has 2 or more episodes, AF is considered recurrent(1). During the last decade, it accounted for
approximately one third of hospital admissions for cardiac arrhythmias with progressive increases in the worldwide prevalence and incidence(1,2). It is
more common in patients with cardiovascular problems such as hypertension, valvular heart disease, congestive heart failure (CHF) or coronary ...
Rate control is the older therapeutic strategy but it is still a primary therapy for AF. Beta–blockers and calcium channel blockers are both effective and
well resistant therapies which can be used in a wide range of acute and long–term clinical conditions, as well as both contribute in controlling
hypertension. It's investigated that oral beta–blockers are more favorable than calcium channel blockers for patients with ischemic heart disease, CHF
and depressed left ventricular function. Digoxin is effective for controlling heart rate especially in sedentary elderly and concomitant CHF patients due
to its effectiveness in improving ventricular function. Other potential advantages of rate control include less adverse drug effects and less
hospitalization. However, it has some disadvantages including risk of toxicity, chronotropic incompetence and difficulties in achieving dose
adjustments in patients with compromised renal function adding that it is not preferred in younger patients and those with a history of

Vincent Van Gogh: A Brief Biography
Vincent Van Gogh lived out these words as he created masterpieces by painting how he perceived the world. Van Gogh had an eccentric
personality, however, continuously suffered from unstable moods and recurrent psychotic episodes caused by Temporal Lobe Epilepsy and Bipolar
Disorder. Despite his suicide in the end, these illnesses correlate with his inability to form stable relationships while also enhancing his artwork.
Vincent was born on March 30 in Zundert, Netherlands to Anne Cornelia Carbonates and Reverend Theodours Van Gogh. Growing up in a very
religious and cultural atmosphere with five siblings, Van Gogh was often the quiet child with few artistic qualities in his earliest years. To help Van
Gogh connect with his cultural and religious side, his parents sent him to boarding school in Zevenbergen and later to another in Tilburg. It was
discovered while Vincent was growing up that he was a very passionate artist, but often doubted himself. This led to two unsuccessful relationships,
after which, he decided to remain in Belgium to study art, with the determination to give happiness to others by creating beauty. In 1870, at the age
of sixteen he was sent to work for The Hague gallery ran by a French art branch of Goupil & Co. after finishing years of academics. Following his
array of work with the branch, Vincent resettled in London to continue promoting Goupil & Co. In London, Van Gogh began focusing intensely on his
religion, while also undergoing a negative

Case Studies on Cardiac Function
Case 1
A.O. is an 89–year–old woman with a long history of systolic heart failure secondary to a large left ventricular infarct when she was in her 70s. She
had poor activity tolerance and required assistance with activities of daily living. Even minimal activity was associated with moderately severe
dyspnea and exertional chest pain, which was relieved by rest. A.O. also exhibited marked pedal edema bilaterally. She is being treated with digitalis,
furosemide (Lasix), KCl, and sublingual nitroglycerin.
Discussion Questions
1. Which type of heart failure (left or right sided) is usually associated with dyspnea?
Left–sided
What other clinical findings are likely to be present with ... Show more content on Helpwriting.net ...
ST depression and T–wave changes may also indicate the development of a non Q–wave MI.
An old MI is evidenced by larger than normal Q waves.
2. What changes in "cardiac enzymes" would be consistent with a diagnosis of MI?
TROPONINS – Markers of choice. Elevated between 4 and 6 hours after the onset of an acute MI and remains elevated for 8–12 days.
MYOGLOBIN – Levels rise between 1 to 4 hours after the onset of chest pain. Highly sensitive.
CREATINE KINASE– comprises of three isoenzymes. 1. Creatine kinase with muscle subunits (CK–MM), which is found mainly in skeletal muscle.
2. Creatine kinase with brain subunits (CK–BB), predominantly found in the brain. 3. Myocardial muscle creatine kinase (CK–MB), found mainly in

the heart.
*CK–MB levels increase within 3 to 12 hours of onset of chest pain.
*Reach peak within 24 hours, and return to baseline after 48 to 72 hours.
*Levels peak earlier if perfusion occurs.
*Sensitivity is approximately 95%, with very high specificity.
3. What is the most common pathophysiologic precipitating event for ACS? What differentiates USA from MI?
MI plaque rupture followed by thrombus formation at the site as the precipitating event.
4. What is the rationale for using thrombolytics in the management of STEMI?
It binds to the fibrin of fresh clots and the resulting compound converts adjacent plasminogen into

Van Gogh Theory
Another theory about the life of Van Gogh was that he did not actually commit suicide but was murdered. A biography of Van Gogh written in 2011
by Steven Naifeh and Gregory White Smith claimed that Van Gogh was actually shot by a teenage boy named Rene Secretan. Apparently, Rene and
his brother would torment Van Gogh very frequently, ranging anywhere from putting salt in his coffee to throwing snakes in his sandbox. On July
27th, while these two boys were out playing with a faulty pistol, a shot went off and struck Van Gogh's abdomen. This writer believes that Van Gogh
claimed that the gun shot wound was self–inflicted because, in Van Gogh's mind, this young boy was putting him out of his misery. Van Gogh was
extremely depressed and felt as though he was a financial burden to his brother, Theo, so by getting shot, and Van Gogh felt as though his absence
would make the world a better place. This theory is widely debated, but more people seem to agree with the theory that Van Gogh ended his own life
and was not in fact murdered. Some believe that Vincent van Gogh did not actually cut off his own ear in an act of insanity. Two German historians
strongly believe that Van Gogh lost his ear during a sword fight with the famous artist that he had a fall out with,Paul Gauguin.
Others have doubt about the theory that Van Gogh cut off his ear in response to a blowout with the painter Paul Gauguin. According to a new theory,
Van Gogh may have actually chopped off his ear after

Answers Lab07 Microcirculation
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S H E E T
NAME ____________________________________
EXERCISE
LAB TIME/DATE _______________________
Frog Cardiovascular
Physiology
Special Electrical Properties of Cardiac Muscle:
Automaticity and Rhythmicity
1. Define the following terms. automaticity: Ability to depolarize spontaneously in the absence of external stimulation. rhythmicity: Depolarization
/repolarization events occur in a regular and continuous manner.
2. Discuss the anatomical differences between frog and human hearts. The frog heart has a single ventricle and two atria.
Dorsally there is an expanded area called the sinus venosus. The human heart has two atria and two ventricles. No sinus venosus ... Show more content

on Helpwriting.net ...
Define partial heart block, and describe how it was recognized in the laboratory. When the 1:1 ratio of atrial to ventricular contractions was replaced
by different whole number ratios, e.g. 2:1, 3:1, the heart was in partial heart block.
13. Define total heart block, and describe how it was recognized in the laboratory. No synchrony between depolarization waves of atria and ventricle.
Impulses not being transmitted from atria to the ventricle; no whole number relationship between atrial and ventricular contractions was demonstrated.
14. What do your heart block experiment results indicate about the spread of impulses from the atria to the ventricles?
In normal heart activity, the ventricles are depolarized by the depolarization wave spreading from the atria.
Observing the Microcirculation Under Various Conditions
15. In what way are the red blood cells of the frog different from those of the human? Frog RBCs are nucleated; human RBCs are anucleate. On the
basis of this one factor, would you expect their life spans to be longer or shorter? Longer
16. The following statements refer to your observation of one or more of the vessel types observed in the microcirculation in the frog's web.
Characterize each statement by choosing one or more responses from the key.
Key: a.
arteriole
b.
venule
c.
capillary
c
1.
smallest vessels observed
a

2.
vessel in which blood flow is rapid, pulsating
c
3.
vessel in which

Review Sheet Exercise 6 Cardiovascular Physiology Essay
REVIEW SHEET
EXERCISE 6
Cardiovascular Physiology
NAME:
LAB TIME/DATE:
1. Define each of the following terms:
autorhymicity– The heart is autorhythmic. This means it generates its own rhythmic action potential independent of the nervous system.
sinoatrial node– is the impulse–generating (pacemaker) tissue located in the right atrium of the heart, and thus the generator of normal sinus rhythm.
pacemaker cells– are specialized cells that cause involuntary muscles and tissues to contract or dilate.
vagus nerves– carry a wide assortment of signals to and from the brain, and they are responsible for a number of instinctive responses in the body.
2. The sympathetic nervous system releases the neurotransmitter– ... Show more content on Helpwriting.net ...
This allows your cardiovascular centres in your brain a little bit more latitude as far as controlling your heart rate. If you were to remove a beating
heart from someone's body you would find that the heart is no longer being suppressed by the parasympathetic nervous system and it will accelerate to
the same pace as the sinoatrial node. The SA node generates action potentials approximately 100 times per minute due to the physiology of the heart,
its own permeability to sodium and calcium via its channels, and a host of other things. Anywhere between 80 to 100 beats per minute is normal for
the SA node.
7. What are two key differences between cardiac muscle and skeletal muscle?
cardiac is involuntary, skeletal is voluntary cardiac is unstriated, skeletal is striated
8. What is the difference between the effective refractory period and the relative refractory period?
The effective refractory period is the time in which the cell is incapable of responding to a second stimulus between the phases of 0–3.5, while the
relative refractory period is the time in which the cell is making preparations to receive stimulus between phase 3.5–4.

9. When the heart is externally stimulated just after the start of the contraction cycle, why does this have no affect on heart rate?
This is because once a contraction has started, the action potential has already fired, stimularing the muscle fibers. Once they

Congestive Heart Failure Research Paper
Melissa Philippi
Health and Human Diseases
Congestive Heart Failure
Description Congestive Heart Failure or CHF means that your heart doesn't pump blood efficiently enough for all your body's tissues and organs to
work properly. This causes fluid retention and swelling in the legs and ankles and also congestion in the lungs.
Etiology
Congestive Heart Failure (CHF) can develop quickly, but most of the time it develops slowly over time. CHF develops as a result of other things that
damage the heart. Common conditions are: untreated high blood pressure, coronary artery disease, heart attack, cardiomyopathy (disease of the heart
muscle), myocarditis (inflammation of the heart muscle), endocarditis (infection of the inner lining of the heart ... Show more content on
Helpwriting.net ...
Nonsurgical treatment usually involves medications such as diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), nitrates, digitalis,
potassium, aspirin, calcium channel blockers, blood thinners, and beta blockers. Some surgical treatments include pacemakers, implantable
cardioverter defibrillators (ICDs), intra–aortic balloon pump, ventricular assist devices (VADs), an implantable artificial heart, angioplasty and
coronary bypass surgery, heart–valve surgery, heart transplantation, and myocardial replacement therapy. Some alternative medicines include
antioxidants, homocysteine metabolism, magnesium, taurine, carnitine, essential fatty acids, diet, herbs, acupuncture, massage, biofeedback, and

Case Study
This is the first case study that is required for the class. Please submit a paper (doesn't have to be long; you could even give me bullet–point answers
to the questions listed below) that answers all of the questions posed after Case Study 1. I have included an easy second case study which, if you
complete it, will be worth extra credit. Answers to the first Case Study are worth 25 points and responding to Case Study 1 is required work for the
course. The extra credit, which is not required, will be worth a total of 10 points. Please check the syllabus for the due date.
Case 1
A.O. is an 89–year–old woman with a long history of systolic heart failure secondary to a large left ventricular ... Show more content on Helpwriting.net
...
Tropopins elevated between 4–6 hours after the onset of an acute MI and remains elevated for 8 to 12 days. Myoglobin levels rise within 1–4 hours
after the onset of chest pain. Creatine kinase –MB increase within 3 to 12 hours of onset chest pain, reach peak within 24 hours and return to baseline
after 48 to 72 hours. 3. What is the most common pathophysiologic precipitating event for ACS? What differentiates USA from MI?
Unstable angina. Unstable angina is a warning sign that a heart attack may happen soon and MI is a heart attack. 4. What is the rationale for using
thrombolytics in the management of STEMI?
To try an break up the clot before it can cause a massive heart attack possibly leading to death. 5. Why are morphine and nitroglycerin used to manage
ischemic chest pain?
Morphine reduces anxiety and catecholamine secretion and is a preload reducer. Nitroglycerine causes relaxation of vascular smooth muscle, which
decreases preload and reduces

Cardiac Overloads
Abstract
Cardiac output is the amount of blood the heart pumps in 1 minute and depends on heart rate, contractility, preload, and afterload. Understanding the
supply and the practical relevance of each of these four components is important in interpreting the values of cardiac output.
Afterload is the intraventricular pressure sufficient to open the aortic valve allowing ejection of the ventricular contents, Or the load against which the
ventricle contracts or otherwise stress the wall during ventricular ejection.
On the right side, it is expressed as Pulmonary Vascular Resistance (PVR) and on the left side as Peripheral Vascular Resistance (SVR). The greater the
afterload, the lower the cardiac output, the greater the pressure of the right atrium.
The higher the aortic pressure, the higher the LV afterload. It is usually measured at the end of systole. The most common influence on afterload is
vascular tone or resistance to blood flow. In addition, other factors, such as valve stenosis or blood viscosity, can affect the afterload. Vascular
resistance is controlled and manipulated with drugs to increase or decrease afterload.1–2
When considering post–load equivalent to systolic stress, an interrelation and interdependence between preload and afterload are revealed.
The increase in afterload ... Show more content on Helpwriting.net ...
Diuretics and digitalis constitute conventional therapy for congestive heart failure, but systemic vasodilators offer an innovative approach in acute and
chronic heart failure by decreasing the increase in systolic wall ventricular stress by reducing aortic and/or impedance reduces cardiac venous return.
As a result, vasodilators increase cardiac output (CO) by decreasing peripheral vascular resistance (PVR) and/or decrease left ventricular end–diastolic
pressure (LVEDP) by decreasing venous

A Summary Of Heart Failure
When the heart begins to fail, mechanisms are activated to compensate for the impaired function and maintain the cardiac output. The primary
compensatory mechanisms are Frank –Starling mechanism, neuroendocrine responses including activation of the sympathetic nervous system and the
renin– angiotensin–aldosterone system, and ventricular hypertrophy. Decreased cardiac output initially stimulates aortic baroreceptors, which in turn
stimulate the SNS. SNS stimulation produces both cardiac and vascular responses through the release of norepinephrine. Norepinephrine increases heart
rate and contractility by stimulating cardiac beta– receptors. Cardiac output improves as both heart rate and stroke volume increase. Norepinephrine
also causes arterial ... Show more content on Helpwriting.net ...
Chest pain (angina) is an indicator of a heart attack (myocardial infarction). A heart attack can cause sudden death. My patient has congestive heart
failure. He has pleural effusion on his lung also called "water on the lung," which is an excessive buildup of fluid between your lungs and chest
cavity. He also has edema in both legs and feet. The client has shortness of breath while lying and has to sleep with three pillows at night due to his
CHF. The pleural effusion on the lungs causes a crackle sound in all four of his lobes. During the stay at the hospital my patient received oxygen
treatments once per day. He may possibly get a thoracocentesis or pleural tap in the future. My patient was on an IV drip, Bumetanide, which inhibits
reabsorption of chloride and sodium. This medication is used to treat his CHF and edema along with another medication

Understanding Heart Failure

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