Cardiac - Welcome to the Community College of Philadelphia 心脏-欢迎来到费城的社区学院.ppt

Cardiac Community College of Philadelphia Nursing 132 Spring 2007 Anatomy and Physiology Review Structures Chambers Valves Arteries Physiology Direction of flow Preload Afterload Coronary Circulation Structure Epicardium Myocardium Endocardium Chambers Right and Left Atria Right and left Ventricles Valves Atrioventricular Tricuspid - Separates RA from RV Mitral - Separates LA from the LV Semilunar Pulmonic – Separates RV from the Pulmonary Arteries Aortic – Separates LV from the Aorta Physiology Blood flow through the heart /kw/pharm/hyper_heart1.html Cardiac conduction Automaticity Electrophysiology Nodes Pathway Automaticity Cardiac conduction Basic EKG Interpretation What is an EKG and what does it measure/record? PQRST Measuring boxes Horizontal measure time: small box 0.04 seconds Large box 0.20 seconds Vertical voltage: small box 1mm or 0.1 mV large box 5mm or 0.5 mV P wave Atrial depolarization Small, smooth, rounded No taller than 2.5 mm No wider than 0.11 sec Q wave First downward deflection Should be less than 0.03 seconds in duration and less than 25% of the R wave Indicates myocardial infarction QRS Complex Represents ventricular depolarization T wave Ventricular repolarization Usually rounded Should be same direction as QRS Inverted T waves can be a sign of ischemia Peaked T waves can be a sign of hyperkalemia U wave Small rounded wave not always present, thought to be part of ventricular repolarization PQRST Chronic Stable Angina Angina (Stable Chronic) Most common sign of ischemic heart disease Myocardial oxygen demand is increased by exercise, smoking, eating heavy foods, weather extremes, emotional distress, etc… Atherosclerosis causes progressive fixed narrowing of the arterial lumen Relieved by rest or pharmacological interventions Goal is to prolong survival, reduce disease progression Acute Coronary Syndrome (ACS) Unstable Angina (UA) Non-ST Elevated Myocardial Infarction (NSTEMI) ST Elevation Myocardial