Cardiac Cycle & Physiology

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CARDIAC CYCLE and PHYSIOLOGY

Diastole (Relaxation Phase):

Ang period ng ventricular filling kung saan ang apat na chambers ay nagrerelax simultaneously.

Systole (Contraction Phase):

Ang refers sa events sa puso tuwing nagko-contract ang chambers.

Note: Hindi sabay ang atrial at ventricular systole! Unang nangyayari ang Atrial Systole (sa huling bahagi ng diastole), at susundan ng Ventricular Systole para ma-eject o maipush ang dugo.

Note: Ang Left Ventricle ay twice to three times MORE muscular kaysa Right Ventricle! kase kailangan ng LV na labanan ang high-pressure system sa Aorta at systemic arteries, ang RV naman ay nagko-contract lang against sa low-pressure system ng pulmonary arteries at capillaries.

STEP-BY-STEP BLOOD FLOW PROCESS

One. DEOXYGENATED BLOOD (Right Side / Blue Blood)

Two. OXYGENATION PROCESS

Eight. Lungs:

Three. OXYGENATED BLOOD (Left Side / Red Blood)

CARDIAC ELECTROPHYSIOLOGY

CARDIAC CONDUCTION PATHWAY

Step-by-Step Flow:

CARDIAC ACTION POTENTIAL (Five Phases)

Phases

REFRACTORY PERIOD

CARDIAC PHYSIOLOGY

COMMON ASSESSMENT FINDINGS IN CARDIOVASCULAR DISEASE

Two. Cold Skin and Diaphoresis

Three. Pain and Pallor of the Fingertips or Toes

Four. Central vs. Peripheral Cyanosis

Five. Edema

Six. Rubor

Seven. Feet and Ankle Ulcers

Arterial Ulcers:

Eight. Xanthelasma

Nine. Dyspnea and Orthopnea

Ten. Jugular Venous Distention

Eleven. Heart Murmurs and Extra Heart Sounds

Twelve. Changes in Vital Signs

PRECORDIAL LANDMARKS

Normal Heart Sounds Baseline:

Abnormal Heart Sound:

S four (Atrial Gallop):

Grading System of Murmur Intensity: Use Diaphragm and Bell of Stethoscope

DIAGNOSTIC STUDIES

a. Cardiac Biomarker Analysis

b. Lipid Profile

c. Brain (B-Type) Natriuretic Peptide

C-Reactive Protein (CRP / hs-CRP)

Homocysteine

Two. Chest X-Ray:

Three. Fluoroscopy:

Four. Electrocardiogra

Chest (Precordial) Leads:

Nursing Interventions for Cardiac Monitoring

Five. Cardiac Stress Testing

Main types

a. Exercise Stress Test

Nursing interventions

b. Pharmacological Stress Test

Nursing interventions

Six. Radionuclide Imaging / Nuclear Cardiology Imaging

Myocardial Perfusion Imaging

Two major techniques

Perfusion Defects

a. SPECT

Nursing Interventions

b. PET

Nursing Interventions

Seven. Coronary CT Angiography (Coronary CTA)

Nursing Interventions:

Eight. Magnetic Resonance Angiography (MRA)

Nursing Intervention:

Nine. Echocardiography

a. TEE - Transesophageal Echocardiography

Nursing Interventions:

b. TTE - Transthoracic Echocardiography

Nursing Interventions:

Ten. Cardiac Catheterization

Pre-procedure

Nursing Interventions:

Contrast-Induced Nephropathy

Vasovagal Response - Management

Eleven. Electrophysiologic Studies

Nursing Interventions

Twelve. Hemodynamic Monitoring

a. Central Venous Pressure

b. Pulmonary Artery Pressure Monitoring

c. Intra-Arterial Blood Pressure Monitoring

Nursing Interventions:

ARRHYTHMIAS AND CONDUCTION PROBLEMS

Two. Electrocardiogram (ECG)

Waves, Complexes, & Intervals

a. P Wave

b. PR Interval

c. QRS Complex

d. ST Segment

e. T Wave

f. QT Interval

Three. Determining Heart Rate from ECG

b. Irregular Rhythm

Four. Determining Heart Rhythm from ECG

· P-P Interval

SINUS BRADYCARDIA

. ECG Characteristics

"Slow Pulse - Low Perfusion"

. Management

Three. If atropine is ineffective

Four. Monitor

SINUS TACHYCARDIA

· Causes - "F-A-S-T-H-E-R"

· ECG Pattern

· Management

· Example:

Two. Vagal maneuvers

Three. Adenosine

Four. IV beta-blockers / calcium channel blockers

Five. Cardioversion

SINUS ARRHYTHMIA

· Classic pattern:

. Characteristics

ATRIAL ARRHYTHMIAS

· Examples:

a. PREMATURE ATRIAL COMPLEXES (PACs)

· Causes:

· Characteristics:

· Management:

b. ATRIAL FIBRILLATION (AFib)

· Classification:

· Causes:

. Medical Management (AFib)

One. Antithrombotic drugs

Two. Antiarrhythmics/rate control

Three. Electrical cardioversion

Four. Catheter Ablation Therapy

. Can use extremely cold temperature - cryoblation Procedure:

Five. Maze Procedure

Six. Convergent Procedure

c. ATRIAL FLUTTER

· Management:

VENTRICULAR ARRHYTHMIAS

a. PREMATURE VENTRICULAR CONTRACTIONS (PVCs)

. Management

b. VENTRICULAR TACHYCARDIA (VT)

· Management

Five. Implantable Cardioverter Defibrillator (ICD)

Six. Magnesium Sulfate

c. VENTRICULAR FIBRILLATION (VF)

· Management

d. VENTRICULAR ASYSTOLE

· Management

CONDUCTION ABNORMALITIES / ATRIOVENTRICULAR (AV) BLOCKS

a. FIRST-DEGREE AV BLOCK

. ECG Characteristics

b. SECOND-DEGREE AV BLOCK

. ECG Characteristics

TYPE TWO - Mobitz Two

· ECG Characteristics

THIRD-DEGREE AV BLOCK

ADJUNCT MODALITIES AND MANAGEMENT

a. Cardioversion

b. Defibrillation

· Emergency/life-saving intervention

○ Safety steps

Two. PACEMAKER

· Indications:

· Components:

. Nursing Interventions

Three. IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR (ICD)

· Indications for ICD:

MANAGEMENT OF PATIENTS WITH CORONARY VASCULAR DISORDER

. Atherosclerosis - Major Cause of CAD

· Risk Factors

Pathophysiology

Clinical Manifestations of CAD

Two. Lipids plus inflammatory cells enter

Clinical Manifestations

Normal Lipid Profile

Management of CAD

Regular moderate physical activity

Antilipidemic Medications

Bile Acid Sequestrants

Cholesterol Absorption Inhibitor

Proprotein Convertase Subtilisin-Kexin Type nine (PCSK nine) Agents

Control Other Risk Factors

Two. ANGINA PECTORIS

Types of Angina

Clinical Manifestations:

Precipitating Factors

· Diagnostic Tests

Two. Cardiac Biomarkers

Three. Stress Test

Four. Coronary Angiography

· Management of Angina

One. Nitroglycerin - immediate relief

Two. Beta-Blockers

Three. Calcium Channel Blockers

Four. Antiplatelets

Five. Anticoagulants

Six. Oxygen Administration

Three. ACUTE CORONARY SYNDROME

· Pathophysiology

· Diagnostic Tests

Three. Creatine kinase-MB - cardiac enzyme that can increase with myocardial injury.

· Electrocardiogram Findings:

· Management

· Nursing Interventions:

Coronary Artery Bypass Graft

· Indications:

· Graft Vessels Used

· Traditional CABG Procedure

Nursing Interventions

Two. POSTOPERATIVE CARE

CARDIO PT. Two

Mitral Valve Prolapse (MVP)

Assessment and Diagnostic Tests

Medical Management

Nursing Management

B. Mitral Regurgitation (MR)

Etiology / Risk Factors

Assessment and Diagnostic Tests

Medical Management

c. Mitral Stenosis (MS)

Assessment and Diagnostic Tests:

Prevention

Medical Management

d. Aortic Regurgitation (AR)

Etiology / Risk Factors

Pathophysiology:

Assessment and Diagnostic Tests

Medical Management

E. Aortic Stenosis

Causes/Risk Factors:

Pathophysiology:

Clinical Manifestations:

Diagnostic Tests:

SURGICAL MANAGEMENT OF HEART VALVE DISORDERS

Nursing Management

INFECTIOUS DISEASES OF THE HEART

Etiology / Risk Factors:

Clinical Manifestations:

Infective Endocarditis

Risk Factors

Diagnostic Tests

Pathophysiology:

Characteristic Manifestations

Prevention

Medical Management

Nursing Management

c. Myocarditis

Etiology:

Pathophysiology

Diagnostic Tests and Findings

Clinical Manifestations

Medical Management

Nursing Management

d. Pericarditis

Risk Factors

Pathophysiology

Diagnostic Tests:

Medical Management

Nursing Management

Complications from Heart Disease

Types of Heart Failure:

Pathophysiology:

Clinical Manifestations

Right-sided Heart Failure

Important Terms

Diagnostic Tests

Medical Management

Pharmacologic Therapy

Nursing consideration: Check for hypotension, kidney function, at potassium level.

Nutritional Therapy

Procedural and Surgical Interventions

Nursing Management

b. Thromboembolism

Pathophysiology:

Clinical Manifestations:

Diagnostic Tests:

Medical Management:

Nursing Management:

c. Pericardial Effusion

Effects of Pericardial Effusion & Cardiac Tamponade

Pathophysiology:

Clinical Manifestations

Diagnostic Tests

Medical Management

d. Cardiac Arrest

Emergency Management

Medications used in Cardiopulmonary Resuscitation:

VASCULAR AND PERIPERAL CIRCULATION DISORDER

Types of Atherosclerotic Lesions

Risk Factors

Clinical Manifestations

Medical Management

Surgical Management

Nursing Management

Peripheral Artery Disease

Clinical Manifestations:

Pathophysiology

Diagnostic Tests:

Medical Management:

Nursing Management:

Aneurysm

Risk Factors:

Clinical Manifestations:

Signs of Rupture (EMERGENCY):

Pathophysiology (AAA)

Diagnostic Tests:

Medical Management:

· Nursing Management:

d. Raynaud's Disease/Phenomenon

. Types of Raynaud's:

· Triggers:

. Clinical Manifestations:

· Pathophysiology

· Medical Management:

· Nursing Management:

e. Venous Thromboembolism (VTE)

. Virchow's Triad (three causes of clot formation):

· Pathophysiology (DVT)

. Clinical Manifestations:

· Diagnostic Tests:

· Medical Management (DVT):

· Nursing Management (DVT):

· Warfarin Patient Teaching:

f. Pulmonary Embolism (PE)

. Pathophysiology

Clinical Manifestations

Diagnostic Tests

Medical Management

Nursing Management

G. Chronic Venous Insufficiency (CVI)

Pathophysiology (CVI)

Clinical Manifestations

Management (CVI)

H. Varicose Veins (Varicosities)

Clinical Manifestations

Diagnostic Tests

Prevention

Medical Management

Nursing Management

I. Lymphedema

. Pathophysiology

. Medical Management

j. Cellulitis

. Clinical Manifestations

. Medical Management

. Nursing Management

k. Hypertension (HTN)

. Risk Factors

· Classifications

· Assessment & Diagnostic Tests

. Pathophysiology of Hypertension

· Medical Management

Second-line antihypertensives

Nursing Management

Hypertensive Crisis

Overview

This document explains the structure and function of the heart, highlighting the cardiac cycle's phases, electrical activity, and blood flow pathways. It includes detailed descriptions of anatomical components, including valves and chambers, along with important physiological concepts such as cardiac output and common signs of cardiovascular disease.

Key Points

1The cardiac cycle consists of diastole and systole phases for efficient blood circulation
2Oxygenation and deoxygenation processes are crucial for maintaining blood oxygen levels
3The conduction system regulates the heart's rhythm through SA and AV nodes
4Key cardiovascular assessment findings include clubbing, cyanosis, and edema

Details

Category: Health and Medicine

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