Chapter 18Disorders of Cardiac Function.ppt

Chapter 18Disorders of Cardiac Function Disorders That Affect the Whole Heart Pericardial disorders Coronary heart disease Myocardial diseases These disorders can cause symptoms of both right- and left-sided heart failure The Pericardium Surrounds the Heart Pericarditis Inflammation of the pericardium causes: Pain Exudate Serous ? pericardial effusion Cardiac tamponade: rapid accumulation of exudate compresses the heart Fibrous ? friction rub; adhesions ECG changes Pericarditis (cont.) Inflammation of the pericardium may restrict the heart’s movement due to: Serous exudate filling the pericardial cavity (pericardial effusion) Fibrous scar tissue making the pericardium stick to the heart (constrictive pericarditis) Consequences ofPericardial Effusion Question What is the immediate treatment for severe cardiac tamponade? Oxygen Cardiac drugs Surgery Pericardiocentesis (removal of fluid from the sac with a needle) Answer Pericardiocentesis (removal of fluid from the sac with a needle) Rationale: In severe cardiac tamponade, there is so much fluid in the pericardial sac compressing the heart that its function declines rapidly. The fluid must be removed quickly by inserting a needle into the pericardial space and aspirating the accumulated fluid. Pulsus Paradoxus On inhaling, the right ventricle fills with extra blood Because the heart cannot expand fully when the right ventricle is overfilled, the left ventricle is compressed and cannot accept much blood On the next heartbeat, the left ventricle does not send out much blood: systolic BP drops Coronary Heart Disease Atherosclerosis blocks coronary arteries Ischemia may cause: Angina Heart attack Cardiac arrhythmias Conduction deficits Heart failure Sudden death Chronic Ischemic Heart Disease Imbalance in blood supply and the heart’s demands for oxygen Less blood Atherosclerosis Vasospasm Thrombosis Higher oxygen demand Stress Exercise Cold Kinds of Angina Stable angina Pain when heart’s oxygen demand incre