The document discusses cardiac anatomy and physiology. It describes the heart's location in the chest, its layers including the pericardium, myocardium and endocardium. It lists the four heart valves that control blood flow and terms related to heart function such as stroke volume and cardiac output. Assessment techniques for the heart like inspection, palpation and auscultation are also mentioned along with common causes of chest pain and risk factors for heart disease.

1. Cardiac Anatomy and Physiology

2. Overview Anatomy and Physiology Terms

3. Anatomy and Physiology The body needs O 2 to support daily activity blood is that delivery system the heart is the medium to supply the blood 100,000 beats in 24 hours 5-20 litres per minute Responds to activity

4. Anatomy and Physiology

5. Anatomy and Physiology Positioned behind sternum Apex at 5 th intercostal space mid-clavicular Base 1.5cms left of sternum Approx 10cms long Weights 270gms

6. Anatomy and Physiology

7. Anatomy and Physiology

8. Anatomy and Physiology

9. Anatomy and Physiology Pericardium Layered fluid filled sac surrounds heart Epicardium Single layer Myocardium Muscular wall of heart Endocardium Inner surface of heart forms valves

10. Anatomy and Physiology Aortic Mitral Pulmonary Tricuspid Control one-way flow of blood Formed from folds of endocardium and fibrous tissue

11. Anatomy and Physiology

12. Anatomy and Physiology

13. Anatomy and Physiology

14. Terms Atrial kick Pre-load After-load Contractility Stroke Volume Cardiac output Cardiac reserve

15. Terms: atrial kick The amount of blood pumped into the ventricles resulting from atrial contraction.

16. Terms: pre-load The stretch of the myocardial fibres at end diastole, The ventricle end diastolic pressure and volume.

17. Terms: after-load The resistance, against which the ventricle must eject its volume of blood during contraction. The resistance is produced by the volume blood already in the vascular system and the vessel walls.

18. Terms: contractility The ability of the cardiac muscle fibres to contract or shorten Frank-starlings law

19. Terms: stroke volume The amount blood ejected by ventricle during contraction, Ejection fraction proportion of blood expelled in contraction compared to filling volume, Normally 65% used as measure of normal LV function,

20. Terms: cardiac output CO = HR x SV BP = CO x SVR Cardiac Index = cardiac output of pt per square metre of body surface area

21. Terms: cardiac reserve

22. Cardiac Assessment

23. Overview Physical Assessment Inspection Palpation (Percussion) Auscultation History

24. Assessment Inspection Palpation (Percussion) Auscultation

25. Assessment Inspection JVP Oedema Colour

26. Assessment Palpation Pulse Oedema Capillary refill Blood pressure

27. Assessment Auscultation Normal S1 S2 Abnormal S2 split S3 S4

28. Assessment

29. Assessment

30. Assessmen t

31. Pneumothorax Myocardial Infarction Respiratory Infection Angina Musculoskeletal Pericarditis Aortic Dissection Trauma Anxiety Pulmonary Embolism Oesophageal Reflux / Spasm Causes of chest pain

32. Case 1: 40 year old man 2 hours central chest pain Radiating to (L) arm Pale, cold, clammy Case 2: 55 year old woman 1 hour generalised weakness and unwell Discomfort in throat Who is having a MI?

33. Diabetes High Blood Pressure Physical Inactivity Over 40 Vascular Disease High Cholesterol Previous MI Obesity Smoking Family History Unhealthy Dietary Habits Risk Factors

34. Early Recognition and Assessment Early Access Early CPR Early Defibrillation Early Advanced Cardiac Life Support Chain of Survival

35. Case 1: 40 year old man 2 hours central chest pain Radiating to (L) arm Pale, cold, clammy Triage: Rapid Assessment Prioritise Injury / Illness Allocate Triage Category Scenario

36. Primary Assessment A – clear and open B – spontaneous, AE R=L o added sounds C – tachycardic - weak, diaphoretic D – GCS 15, PEARL, full ROM / Strength / Sensation all limbs Secondary Assessment E – Change into patient gown F – Observations: R: 28, P: 120, BP: 149/66, T: 37 2 , (monitor) BSL: 6.9, Pain 5/10, SpO 2 99% RA G – Comfort measures H – Detailed history / Family History / heat-to-toe assessment Time = Muscle Assessment

37. lleregies A M P L E edications revious medical, surgical and family history ast meal vents Assessment

38. osition: Where is the Pain? P Q R S T A A A uality: What does the pain feel like? [sharp, dull, burning] adiation: Does the pain move anywhere? everity: Rate the pain on a scale between 0 and 10 iming: When did the pain start? Is it continuous? lleviating factors: What makes it better? ggravating factors: What makes it worse? ssociated symptoms: e.g., nausea / pins and needles Assessment

39. Inspect Palpate Percussion Auscultation Assessment

40. Notify Nursing Team Leader and Senior Doctor Primary B – Supplementary Oxygen C – ECG Nursing Intervention

41. Nursing Intervention

42. Ineffective cardiopulmonary tissue perfusion related to reduced coronary blood flow Notify Nursing Team Leader and Senior Doctor Primary B – Supplementary Oxygen C – ECG IVC 18g Bloods to pathology (FBC, UEC, CP, CK, Troponin, ABG) Secondary F – Observations G – Analgesia / Medications Reassurance, bed rest, patient and family education Nursing Intervention

43. Interpretation of ECG Chest X-Ray IVC  bloods to pathology Medications Anginine Aspirin Morphine GTN infusion Clopidogrel Heparin Cardiology Review Treatment Options PTCA Thrombolysis Medical Intervention