The most beautiful things in life cannot be seen or even touched, They must be felt with the heart

. -Helen Keller

Heartaches
Gerald P. Valenzuela

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Cardiovascular pertaining to heart and blood vessels Heart  Blood vessels  Blood  .

Heart Pericardium  Pericardial fluid  Walls  – Epicardium – Myocardium – Endocardium .

Heart Chambers 2 Atria  Interarterial septum  2 ventricles  Interventricular septum  .

Heart Valves Tricuspid valve TV  Pulmonary semilunar valve  Mitral valve or bicuspid valve  Aortic or semilunar valve  .

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The Blood Supply of the Heart .

The Circulatory System .

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Be still my beating heart……… .

My Heartbeat       The conduction system Electrical impulses Sinoatrial Node SA Atrioventricular Node AV node Bundle of His Purkinje fibers .

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caused by closing of semilunar valves as blood is pumped out of the heart  .Heart Sounds S1 lubb sound – caused by the tricuspid and mitral valve closing between the atria and ventricles  S2 dupp sound – shorter and higher pitch.

mercury  .Pulse and Blood Pressure Pulse  Blood Pressure  Systolic pressure  Diastolic Pressure  Hg .

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clotting proteins  Serum – plasma minus clotting proteins  Fibrinogen and prothrombin are clotting proteins  . hormones and waste products.The Blood Plasma – nutrients.

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The Blood Erythrocytes – mature RBCs  Reticulocyte – young  Hemoglobin – iron containing pigment which binds oxygen  Lifespan 120 days  .

The Blood Leukocytes – immunity & protection  Neutrophils  Basophils  Eosinophils  Lymphocytes  Monocytes  .

The Blood Thrombocytes – platelets  Not cells. but fragments of megakaryocytes  For clotting blood  .

AB. B. O O only . AB.Blood Types Blood Type A B AB (universal recipient) O (universal donor) Can Donate to Can Receive From A or AB only B or AB only AB only A or O only B or O only A. O A. B.

The Rh factor         Rhesus monkeys Rh (+) presence of antigen Rh (-) Mother is Rh.and Father is Rh+ Baby inherits Rh+ Mother develops Ab against Rh antigen 2nd pregnancy will result to erythroblastosis fetalis Tx: Rh immune globulin or Rhogam .

Medical Specialties related to Cardiovascular System Cardiologist  Hematologist  .

is atherosclerosis of the coronary arteries that may cause angina pectoris. myocardial infarction and sudden death.  . CAD. End-stage coronary artery disease is the final phase of CAD characterized by unrelenting angina pain and a severely limited lifestyle in which medication is the only remaining treatment option.Pathology of the Cardiovascular System  Coronary Artery Disease.

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CAD  Atherosclerosis is hardening and narrowing of the arteries due to a buildup of cholesterol plaques or fatty substance. .

CAD   An atheroma which is characteristic of atherosclerosis. This type of plaque (PLACK) is similar to the buildup of rust inside a pipe and it may protrude outward into the opening of the vessel or move inward into the wall of the vessel. . is a plaque within the arterial wall.

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is a group of cardiac disabilities resulting from an insufficient supply of oxygenated blood to the heart that is usually associated with CAD.  . IHD.  Ischemic heart disease.CAD Ischemia is a deficiency in blood supply due to either the constriction or the obstruction of a blood vessel.

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. incomplete blockage of.CAD  Angina pectoris is severe episodes of spasmodic choking or suffocating chest pain. the supply of oxygen to the myocardium.

An infarct is a localized area of necrosis caused by interruption of the blood supply. Damage to the myocardium impairs the heart’s ability to pump blood through the body.a. heart attack or MI. is the occlusion of a coronary artery resulting in an infarct of the affected myocardium.k.CAD A myocardial infarction a. .

the kidneys retain more fluid within the body and this fluid accumulates in the legs. . ankles and lungs.Congestive Heart Failure  CHF. In response to the reduced blood flow. The term congestive refers to this fluid buildup. is a syndrome in which the heart is unable to pump enough blood to meet the body’s needs for oxygen and nutrients.

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inflammation of the lining or valves of the heart caused by bacteria. Myocarditis – Rheumatic heart fever.Carditis   Endocarditis Bacterial endocarditis . rheumatic heart disease   Pericarditis .

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Heart Valves   Valvulitis Mitral valve prolapse is an abnormal protrusion of the mitral value that results in the incomplete closure of the valve. The sound of this abnormal flow is called a heart murmur. Mitral stenosis .narrowing Tricuspid stenosis A valve that does not function properly may allow blood to flow back into the heart chamber.    .

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Ventricular Septal Defects VSD

Tetralogy of Fallot •Pulmonary Stenosis

•Overriding of the aorta
•Ventricular septal defect •Right ventricular hypertrophy

Tachycardia is an abnormally fast heartbeat.    . Palpitation is a pounding or racing heart with or without irregularity in rhythm. This term is usually applied to rates over 100 beats per minute.. Flutter . Paroxysmal tachycardia is a fast heartbeat of sudden onset.a. dysrhythmia Bradycardia .Arrythmias    Cardiac arrhythmia a.abnormally slow heartbeat.a cardiac arrhythmia in which the atrial contractions are rapid but regular.k. This is associated with certain heart disorders or it may be a response accompanying a panic attack.

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Fibrillation  rapid. Ventricular fibrillation. This produces an irregular quivering action of the atria and a very rapid ventricular heartbeat.   . Atrial fibrillation. V fib. A fib. is the result of irregular contractions of the ventricles and is fatal unless reversed by electric defibrillation. the atria beat faster than the ventricles. random and ineffective contractions of the heart.

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. Angionecrosis      Angiospasm Angiostenosis Hemangioma Hypoperfusion is a deficiency of blood passing through an organ or body part.k.a.Blood Vessels  Angitis a. vasculitis is the inflammation of a blood or lymph vessel.

a localized weak spot or balloon-like enlargement of the wall of an artery.Arteries      Aneurysm . Arteritis Polyarteritis Arteriosclerosis Raynaud’s phenomenon consists of intermittent attacks of pallor. . cyanosis and redness of the fingers and toes. These symptoms are due to arterial and arteriolar contraction and are usually caused by cold or emotion.

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 . A varicosity is one area of swelling.Veins  Phlebitis Varicose veins .abnormally swollen veins usually occurring in the legs.

a foreign object. such as a blood clot. Thrombus .blood clot       Thrombotic occlusion Coronary thrombosis Embolus .  . Embolism is the blockage of a vessel by an embolus. quantity of air gas or a bit of tissue or tumor that is circulating in the blood.an abnormal condition in which a thrombus develops within a blood vessel.Thromboses and Embolisms  Thrombosis .

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a. Hemochromatosis a.a. is the presence of pathogenic microorganisms or their toxins in the blood. any abnormal or pathologic condition of the blood.k.a. This is a genetic disorder in which the intestines absorb too much iron. Septicemia.k.   . iron overload disease. blood poisoning. The excess iron enters the bloodstream and accumulates in organs where it causes damage.Blood Disorders  Dyscrasia – bad mixture.

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The presence of cholesterol at certain levels is normal and essential for good health. .Cholesterol  These are lipids that travel in the blood in packages called lipoproteins. A pathologic condition is present when these fats are present in excessive amounts.

Homocysteine is an amino acid normally found in the blood and used by the body to build and maintain tissues. Such increases may be caused by a diet severely lacking in several B vitamins. High-density lipoprotein HDL or good cholesterol because it carries unneeded cholesterol back to the liver for processing and does not contribute to plaque buildup.   Triglycerides are combinations of fatty acids attached to glycerol that are also found normally in the blood in limited quantities.Cholesterol  Low-density lipoprotein LDL or bad cholesterol because excess quantities contribute to plaque buildup in the arteries. when present in elevated levels. However. it can damage arterial walls and increase the risk of coronary artery disease. Hyperlipidemia or hyperlipemia   .

Leukopenia is an abnormal decrease in the number of white blood cell.k. thrombopenia. is an abnormal decrease in the number of platelets. Leukemia is a malignancy characterized by a progressive increase of abnormal leukocytes    . Thrombocytopenia a.a.Blood Cells  Erythrocytosis is an abnormal increase in the number of circulating red blood cells.

 . This is caused by the failure of blood cell production in the bone marrow.Anemias  Anemia is a disorder characterized by lower than normal levels of red blood cells in the blood. Aplastic anemia is marked by an absence of all formed blood elements.

 Iron-deficiency anemia develops if not enough iron is available to bone marrow to make hemoglobin. malabsorption of iron. . or chronic blood loss. pregnancy and lactation.Anemias  Hemolytic anemia . It may be caused by inadequate iron intake.red blood cells are destroyed faster than the bone marrow can replace them.

Anemias  Megaloblastic anemia the bone marrow produces megaloblasts. Pernicious anemia an autoimmune disorder results in the inability of the body to absorb vitamin B12 normally. This type of anemia is almost always caused by a vitamin deficiency.  . These are large abnormal red blood cells with a reduced capacity to carry oxygen.

 .a.k. This abnormal shape interferes with normal blood flow resulting in damage to most of the body systems.Anemias  Sickle cell anemia is a genetic disorder that causes abnormal hemoglobin that result in the red blood cells assuming an abnormal sickle shape. Thalassemia a. is a group of genetic disorders characterized by short-lived red blood cells that lack the normal ability to produce hemoglobin. Cooley’s anemia.

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  . Secondary hypertension is caused by a different medical problem such as a kidney disorder or a tumor on the adrenal glands. Malignant hypertension is characterized by the sudden onset of severely elevated blood pressure.a. It can be life-threatening and commonly damages small vessels in the brain. a. primary hypertension or idiopathic hypertension. is consistently elevated blood pressure of unknown origin. When the other problem is cured.k. the secondary hypertension should be resolved. heart and kidneys. retina.Hypertension  Essential hypertension.

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grade III. 4/6. grade IV. 5/6* grade I. 3/6. grade VI*) heart sound heave holosystolic murmur intercostal space irregularly irregular knock MAT (multifocal atrial tachycardia) midclavicular line mitral valve prolapse mitral regurgitation multifocal atrial tachycardia (MAT) murmur Graham Steell murmur – pulmonary insufficiency Austin Flint murmur – aortic insufficiency murmur radiating to the axilla or neck normal sinus rhythm (NSR) P2 louder than A2 . no third or fourth heart sound fourth heart sound ejection murmur ejection systolic murmur gallop                    grade 1/6.Physical Examination                    A2 louder than P2 aortic click aortic regurgitation apical systolic murmur arrhythmias asystole trial fibrillation (often dictated Ay-Fib or AF) atrial flutter bradycardia cardiomegaly click diastolic murmur first heart sound (S1) first and second heart sounds normal. grade II. grade V. 2/6.

capillary pulsations Pulsus paradoxus – Aortic insufficiency . S2. no S3 or S4               S3 gallop second heart sound (S2) supraventricular tachycardia (SVT) systolic ejection murmur tachycardia third heart sound (S3) thrill tricuspid regurgitation ventricular fibrillation (often dictated Vee-Fib) ventricular tachycardia (often dictated Vee-Tak Corrigan. water-hammer pulse Pistol shot pulse Quincke pulse.premature ventricular contractions regular sinus rhythm (RSR) rapid ventricular response rub S1. S3. S4 S1 equals S2 S1 and S2 normal.point of maximum impulse point of maximum impulse (PMI) in fifth intercostal space premature ventricular contractions (PVC) prosthetic click/sound PVC .Physical Examination               parasternal border pericardial knock physiologic split of S2 PMI .

catheter is passed into a vein or artery and is guided into the heart. Phlebography    .Diagnostic Procedures of the Cardiovascular System  Angiography is a radiographic study of blood vessels after the injection of a contrast medium. Angiocardiography Cardiac catheterization .

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Stress tests are ECGs after an exercise    Thalium stress test assess blood flow during stress .Electrocardiogaphy  Electrocardiogram ECG or EKG Holter monitor .ECG monitor 24-hour period.

Ultrasonic Diagnostic Procedures  Echocardiography ECHO. ultrasound of the heart to measure structures and motion Transesophagial echocardiography TEE  .

5% of total CK if total CK is >400 IU/L myocardial infarction in the emergency department This small heme protein becomes abnormal within 1 to 2 hours of necrosis. the elevation can last 10 days.It begins to increase LDH-1 and LDH-2 LDH isoenzymes - Myoglobin .will begin to rise in 8-12 hours and peak Troponin Complex . peaks in 24 hours. peaking at 16 to 30 hours and returning to baseline within 4 days 25-200 U/L 32-150 U/L 6 to 10 hours after an acute MI. 140-280 U/L CK-MB CK isoenzyme . In the acute MI. the LDH 2 remains constant. .early and sensitive diagnosis of Compare LDH 1 and LDH 2 levels. When the LDH 1 is higher than LDH 2. peaks in 4-8 hours. the LDH is said to be flipped. < 0. LDH-1 18%-33% LDH-2 28%-40% in 18-30 hours 10-42 U/L SGOT . however.Peaks in 10-24 hours. the LDH-1 value will be less than the LDH-2. which is highly suggestive of an MI. A flipped pattern appears 12-24 hours post MI and persists for 48 hours. while LDH 1 rises. <1 begins to fall off after 1-2 weeks.Total LDH will begin to rise 2 to 5 days after an MI.Levels rise 4 to 8 hours after an acute MI. < 12 IU/L if total CK is <400 IU/L <3.Laboratory Procedures Creatine phosphokinase (CK) . Normally. and drops to normal in about 12 hours. and remains elevated for up to 72 hours.4 (LDH) Lactate dehydrogenase .

Table of Cardiac markers Serum Markers of Myocardial Injury Detected Peak 1-3 1-8 Falls 12-18 Myoglobin CK/CK-MB MB Isoforms Troponin Complex 3-8 1-6 3-6 12-16 4-8 10-24 24-48 12-48 cTnI: 5-9 days cTnT: 7-14 days .

Typical Marker Values during AMI .

rubella.10.5. (White Blood Cell Count) EOSINOPHILS and EOSINOPHIL COUNT - NEUTROPHILS and NEUTROPHIL COUNT - BASOPHILS and BASOPHIL COUNT - Basophilic activity is not fully understood but it is known to carry histamine.2 mill/mcl Optimal Adult Female Reading: 4. heparin and serotonin.48 % Optimal Adult Reading: 33 Normal Children’s Range: 25 .2 % Optimal Adult Reading: 1 .9 % Optimal Adult Reading: 4.9 Lower ranges are found in Children.55 Normal Adult Male Range: 4.5 PLATELET COUNT MONOCYTES and MONOCYTE COUNT - Elevated levels are seen in tissue breakdown or chronic infections. Normal Adult Range: 0 .400 thous/mcl Optimal Adult Reading: 265 Higher ranges are found in children. newborns and infants this is the main defender of the body against infection and antigens. Normal Adult Range: 0 .8 thous/mcl Optimal Adult Reading: 7.73 % Optimal Adult Reading: 60.R. (Red Blood Cell Count) Hematologic Values Normal Adult Female Range: 3.. Normal Adult Range: 48 . Normal Adult Range: 18 .C.5 % Optimal Adult Reading: 2.5 W.3 Higher ranges are found in children. newborns and infants Normal Adult Range: 3.9 .B. leukemia (monocytic) or .50 % Optimal Children’s Reading: 37. Normal Adult Range: 0 . High levels may indicate an active infection.5 Normal Children’s Range: 30 .8 .B.5 Elevated levels may indicate an allergic reactions or parasites. or infectious mononucleosis. carcinomas. newborns and infants Normal Adult Range: 130 . High levels are found in allergic reactions..6 mill/mcl Optimal Adult Male Reading: 4.lymphomas.2 .60 % Optimal Children’s Reading: 45 LYMPHOCYTES and LYMPHOCYTE COUNT Elevated levels may indicate an active viral infections such as measles.C. chickenpox.5.

47% Optimal Adult Female Reading: 42% Normal Adult Male Range 40 .33 pg Optimal Adult Reading: 30 MCV (Mean Corpuscular Volume) HEMOGLOBIN (HGB) Normal Adult Female Range: 12 .36 % Optimal Adult Reading: 34 Higher ranges are found in newborns and infants .Hematologic Values HEMATOCRIT (HCT) Normal Adult Female Range: 37 .100 fl Optimal Adult Reading: 90 Higher ranges are found in newborns and infants MCHC (Mean Corpuscular Hemoglobin Concentration)  Normal Adult Range: 32 .54% Optimal Adult Male Reading: 47 Normal Newborn Range: 50 .18 g/dl Optimal Adult Male Reading: 16 g/dl Normal Newborn Range: 14 .62% Optimal Newborn Reading: 56 MCH (Mean Corpuscular Hemoglobin) Normal Adult Range: 27 .16 g/dl Optimal Adult Female Reading: 14 g/dl Normal Adult Male Range: 14 .20 g/dl Optimal Newborn Reading: 17 g/dl Normal Adult Range: 80 .

High density lipoproteins (HDL) is desired as opposed to the low density lipoproteins (LDL). metabolic disorders. diabetes. Elevated cholesterol has been seen in artherosclerosis. Normal Adult Range: 35 .studies CHOLESTEROL/LDL RATIO HDL (High Density Lipoprotein) . malignancies. liver disease.Increased levels may be present in artherosclerosis. Normal Adult Range: 0 .A high .130 mg/dl Optimal Adult Reading: 81 mg/dl level of HDL is an indication of a healthy metabolic system if there is no sign of liver disease or intoxication. pancreatitis. hypothyroidism. hypothyroidism and pregnancy. myocardial infarction.6 Optimal Adult Reading: 3. and malabsorption. malnutrition. Decreased levels may be present in chronic obstructive pulmonary disease.240 mg/dl Optimal Adult Reading: 180 correlate the association between high levels of LDL and arterial artherosclerosis Normal Adult Range: 62 .5 LDL (Low Density Lipoprotein) .135 mg/dl Optimal Adult Reading: +85 mg/dl TRIGLYCERIDES . malnutrition. hyperthyroidism. Normal Adult Range: 120 . anemia and infection.200 mg/dl Optimal Adult Reading: 100 Normal Adult Range: 1 . toxemia.Lipid Values CHOLESTEROL . liver insufficiency. and nephrotic syndrome. brain infarction. Low levels are seen in depression. two types of cholesterol.

Treatment Procedures of the Cardiovascular system Antihypertensive Medications  Antihypertensive . The following are medications used for this purpose. Diuretics which increase urine secretion to rid the body of excess sodium and water.administered to lower blood pressure. Calcium channel blockers reduce the contraction of the muscles that squeeze blood vessels tight. interfere with the action of the kidney hormone rennin that causes the heart muscles to squeeze. are administered to treat hypertension and CHF. and arrhythmia.    . angina. which are used to treat hypertension and CHF.  ACE inhibitors. These medications are used to treat hypertension. Beta-blockers slow the heartbeat.

It may be administered sublingually. Vasoconstrictor constricts the blood vessels. Anticoagulant or thrombolytic agent. is used to relieve the pain of angina.k. Antiarrhythmic Tissue plasminogen activator TPA. Vasodilator dilates the blood vessels. is a clot-dissolving enzyme used for the immediate treatment of heart attack victims.a. Nitroglycerin a vasodilator. through the skin or orally as a spray. Digoxin a. digitalis slows and strengthens the heart muscle contractions and is used in the treatment of atrial fibrillation and CHF.        .Additional Medications  Statins a type of cholesterol-lowering drug. are used to reduce LDL cholesterol or other lipids in the blood. slows blood clotting and prevents new clots from forming.

Cardiac glycosides digitoxin (Crystodigin)  digoxin (Lanoxin. Lanoxicaps)  .

Zestril)  quinapril (Accupril)  ramipril (Altace)  .ACE (angiotensin-converting enzyme) inhibitors captopril (Capoten)  enalapril (Vasotec)  fosinopril (Monopril)  lisinopril (Prinivil.

Covera-HS. Procardia)  verapamil (Calan.V. Isoptin.) Calcium channel blockers atenolol (Tenormin) bisoprolol (Zebeta) carterolol (Brevibloc) metoprolol (Lopressor. Toprol) nadolol (Corgard) propranolol (Inderal) amlodipine (Norvasc) bepridil (Vascor) diltiazem (Cardizem) mibefradil (Cardene)  nifedipine (Adalat. Sorbitrate) – isosorbide mononitrate (Imdur) Beta blockers                    Alpha/beta adrenergic blockers carvedilol (Coreg) Nitro-Bid (sustained-release capsule) Nitordisc (transdermal patch) Nitro-Dur (transdermal patch) Nitrogard (transmucosal tablet) Nitrol (topical ointment) Nitrolingual (sublingual spray) Transdermal-Nitro (transdermal patch) Tridil (I.Drug used to treat angina Nitrates  Nitrates given orally: – isosorbide dinirate (Isordil. Verelan) .

Toprol)  propranolol (Inderal)  timolol (Blocadren)  .Drugs used to treat myocardial infarction captopril (Capoten)  lisinopril (Prinivil. Zestril)  quinapril (Accupril)  aspirin  atenolol (Tenormin)  metoprolol (Lopressor.

Quinidex) ibutilide fumarate (Corvert) adenosine (Adenocard) amiodarone (Cordarone) bretylium (Bretylol) disopyramide (Norpace) lidocaine (Xylocaine) mexiletine (Mexitil) moricizine (Ethmozine) procainamide (Procan SR. Quinaglute. Verelan) . Isoptin. Pronestyl) propafenone (Tonocard) Beta blockers (for ventricular arrhythmias)             Drugs for ventricular arrhythmia Calcium channel blockers acebutolol (Sectral) atenolol (Tenormin) bisoprolol (Zebeta) esmolol (Brevibloc) metoprolol (Lopressor) nadolol (Congard) pindolol (Visken) propranolol (Inderal) sotalol (Betapace) timolol (Blocadren) diltiazem (Cardizem) verapamil (Calan.Drugs used to treat arrhythmias Drugs for atrial and ventricular arrhythmias   Drugs for atrial arrhythmias           flecainide (Tambocor) quinidine (cardioquin. Covera-HS.

Isoptin.Calcium channel blockers   Antihypertensive drugs Antiadrenergic drugs  amlodipine (Norvasc) diltiazem (Cardizem)  nifedipine (Adalat. Verelan) Drugs that block α and β receptors Drugs that block α receptors in the brain clonidine (Catapres)  guanabenz (Wytensin)  guanfacine (Tenex)  methyldopa (Aldomet)         carvedilol (Coreg) ACE inhibitors            Angiotensin II antagonists irbesartan (Avapro) losartan (Cozaar)  valsartan (Diovan) benazepril (Lotensin) captopril (Capoten) enalapril (Vasotec) fosinopril (Monopril) lisinopril (Prinivil. Procardia)  verapamil (Calan. Zestril) moexipril (Univasc) quinapril (Accupril) ramipril (Altace) trandolapril (Mavik) Drugs that block α receptors in the blood vessels guanadrel (Hylorel) guanethidine (Ismelin) reserpine Alpha adrenergic blockers Vasodilators doxazosin mesylate (Cardura) prazosin (Minipress) terazosin (Hytrin) hydralazine (Apresoline)  minoxidil (Loniten) . Covera-HS.

hydrochlorothiazide) Apresazide (hydralazine. chlorthalidone) Diupres (reserpine. hydroflumethiazide) Tenoretic (atenolol. hydrochlorothiazide) peripheral vasodilators beta blockers calcium channel blockers Drugs used to treat hypertensive crisis . hydrochlorothiazide) Combipres (clonidine. hydrochlorothiazide) Renese-R (reserpine. methylclothiazide) Hydropes (reserpine.Antihypertensive drugs Combination drugs (An antihypertensive agent with a diuretic)               Aldoril (methyldopa. polythiazide) Salutensin (reserpine. chlorthalidone) Zestoretic (lisinopril. hydrochlorothiazide) Inderide (propanolol. chlorothiazide) Enduronyl (deserpidine.

Drugs used to treat peripheral vascular disease cyclandelate (Cyclan)  isoxsuprine (Vasodilan)  Drugs for intermittent claudication  pentoxifylline (Trental) .

Drugs used to treat hyperlipidemia Bile acid sequestrants           Nonprescription dietary supplements used to teat hypercholesterolemia and hyper triglyceridemia   atorvastatin (Lipitor) cerivastatin (Baycol) cholestyramine (Questran) clofibrate (Atromid-S) colestipol (Colestid) fluvastatin (Lescol) gemfibrozil (Lopid) lovastatin (mevacor) pravastatin (Pravachol) simvastatin (Zocor) niacin (nicotinic acid. Nicolar) omega-3 fatty acids (Promega) .

Resuscitation Drugs Drugs for emergency resuscitation  epinephrine (Adrenalin)  Licodaine (Xyclocaine)  Atropine  Sodium bicarbonate  Calcium chloride Drugs used after successful resuscitation      Drugs used to treat anaphylactic shock epinephrine (Adrenalin) dobutamine (Dobutrex) dopamine (Intropin) isoproterenol (Isuprel) norepinephrine (Levophed) .

Anticoagulant drugs           Platelet aggregation inhibitors abciximab (ReoPro) aspirin dipyridamole (Persantine) ticlopidine (Ticlid) anisindione (Miradon) ardeparin (Normiflo) dalteparin (Fragmin) danaparoid (Orgaran) dicumarol enoxaparin (Lovenox) heparin warfarin (Coumadin)   .

Thrombolytic drugs Tissue plasminogen activators (tPA) alteplase (Activase)  reteplase (Retavase)  Thrombolytic enzymes anistreplase (Eminase)  streptokinase (Kabikinase. Streptase)  urokinase (Abbokinase)  .

Clearing Blocked Arteries  Percutaneous transluminal coronary angioplasty PTCA or balloon angioplasty. .

Clearing Blocked Arteries  Stent placement to prevent restenosis .

the balloon is inflated and a cutting tool is used to shave off pieces of the plaque buildup.Clearing Blocked Arteries  An atherectomy is the surgical removal of plaque from the interior lining of an artery. . After the catheter and balloon are in place.

Clearing Blocked Arteries

Endarterectomy Carotid endarterectomy The artery may be reinforced with a piece of vein taken from the leg. This procedure is performed to reduce the risk of stroke by ensuring the blood flow to the brain.

Coronary Artery Bypass Graft

CABG is also known as bypass surgery. In this surgery which requires opening the chest, a piece of vein from the leg is implanted on the heart to bypass a blockage in the coronary artery and to improve the flow of blood to the heart. Minimally invasive direct coronary artery bypass (MIDCAB), a.k.a keyhole or buttonhole bypass is an alternative technique for some bypass cases. This procedure is performed with the aid of a fiberoptic camera through small openings between the ribs.

 .k.a. CPR. cardioversion Valvoplasty or valvuloplasty Pacemaker for bradycardia and atrial fibrillation Cardiopulmonary resuscitation.Heart    Defibrillation a.

Defibrillation .

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Blood Vessels. Blood and Bleeding  Aneurysmectomy Aneurysmorrhaphy Arteriectomy Hemostasis    .

Blood and Bleeding  Transfusion Plasmapheresis . This is performed to reduce or eliminate harmful substances present in the plasma.Blood Vessels.  . mostly RBCs.a procedure in which the plasma is removed from donated blood and the remaining components. are returned to the donor.

I must be learning something because it hurts. -Tom Tompkins .

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