LEFT-SIDED AND RIGHT

SIDED HEART FAILURE

GROUP 1
TOLENTINO, ARIANNA MARI
TOMAMBILING JALIDA
TUMAMAO , JEHANI
VACALARES, PORTIA IRMA
The heart is about the size of your fist
 HEART
• The heart is chambered muscular organ that
pumps blood receive from the veins into the
arteries, there by maintaining the flow of blood
through the entire circulatory system.
• The heart is also a small organ, it is about 12cm .
• The heart is surrounded by membrane called
Pericardium
• Although it is a single structure, the heart is
actually two pumps in one.
⚫ The right side of the heart pumps blood to the lungs and back to
the left side of the heart through the vessels of pulmonary
circulation

⚫ The left side of the heart pumps blood to all the tissues of the
body and back to the right side of the heart through vessels of
the systemic circulation
The Four Functions of the Heart
Generating blood pressure- Contractions of the heart
generate blood pressure. Which forces the blood through
the blood vessels
Routing blood- The heart separates the pulmonary and
systemic circulation, which ensures the oxygen-rich in
blood tissues
Ensuring one-way blood flow. The valves of the heart
ensure one-way flow of the blood through the heart and
blood vessels
Regulating blood supply. Changes the rate and force of
heart contraction match blood flow of the changing
metabolic needs of tissues during rest, exercise and
changes in body position
SIZE, FORM, LOCATION OF THE HEART

• The heart normally located in the middle and slightly

located in the thoracic cavity between 3rd and 5th ribs
• Weighs about 325 gm is males and about 275 gm in
females
The heart has- apex , base, anterior , posterior
The pointed Apex–is a formed by the tip of the left ventricle
and rest on the diaphragm. It is directed anteriorly,
inferiorly and to the left
The pointed Base the heart is posterior surface. Its formed
by the atria of the heart
ANATOMY OF THE HEART
ANTERIOR VIEW
 Pericardium
• The pericardium
is fibroserous sac
that encloses the
roots of the great
vessels

• The pericardium
lies within the
middle
mediastinum
Bloods enters the aorta of the heart
through vessels called veins.
Artia – is the primary as reserviors,
where the blood returning from the
veins collects before it enters the
ventricle
Ventricles – is the major pumping
chambers they inject blood into the
arteries and force its flow through
the circulatory system
 The heart has four
chambers

▪ Right atrium.
▪ Right ventricle.
▪ Left atrium.
▪ Left ventricle
RIGHT ATRIUM
▪ Receive blood from
the three major
openings:
▪ (1)-superior vena
cava
▪ (2)-the inferior vena
cava
▪ (3)-the coronary
sinus
The svc and ivc drain
blood most of the
body and the smaller
coronary sinus drain
from the most of the
heart muscle
RIGHT VENTRICLE

▪ Pumps blood into

pulmonary trunk
▪ Opens into
pulmonary artery to
pulmonary valve
▪ LEFT ATRIUM

▪ Receives bloods
through the four
pulmonary
veins, which
drain blood from
the lungs

▪ Most chamber
 LEFT VENTRICLE

▪ The wall is thicker

than right ventricle

▪ Contracts more
forcefully and
generates a greater
blood pressure than
the wall of the right
ventricle
▪ Blunt tips forms the
apex of the heart
Heart Valves –
The one –way flow of the
blood the heart chambers is
maintained by heart valves

There major types of

valves

Artioventricular (AV)-
located between each
atrium and ventricle

Semilunar valves (SV)

Located between each
ventricle and associated
great artery
It has four valves

Tricuspid valve: located between the right atrium

and the right ventricle
Pulmonary valve: located between the right
ventricle and the pulmonary artery.
-Mitral valve: located between the left atrium and
the left ventricle.
Aortic valve: located between the left ventricle and
the aorta.
ROUTE OF THE BLOOD FLOW THROUGH THE HEART

https://www.youtube.com/watch?v=jBt5jZSWhMI
ARTERIAL SUPPLY OF THE
HEART

• The arterial supply of the heart is

provided the right and left
coronary arteries, which arise from
ascending aorta above
immediately above the aortic valve

CORONARY ARTERIES

The origin of coronary artiries are as

follow

The left coronary artiries arises from

th aortic sinus immediately above the
left posterior cusps of the aorcotic
valve.

The right coronary artery arises form

the aortic sinuses immediately above
the anterior cusps of the aortic valve.
THE HEART WALL
- is composed of three layers of
tissue

• EPICARDIUM-also called
veseral pericardium is a thin
serous membrane

• MYOCOARDIUM- is
composed of cardiac muscle
cells and is responsible for
contructiF
• ENDOCARDIUM- endothelial
layer if the mayocardial surface
ELECTRICAL ACTIVITY OF THE
HEART

❑ The heart beat specialized cardiac conduction

system

❑ The heart beats normally in an orderly sequence

Contraction of the atria (atrial systole) followed by
contraction of the ventricles (ventricular systole),
during diastole all for chambers are relaxed
CONDUCTION SYSTEM

❑ To the pump blood efficiently , both artia need to contract at

the same time, followed by contraction of both ventricles
(cardiac muscle )

❑ Contraction is coordinated by conduction system which

carries the signal to contract to the heart

❑ Intercalated disks allows signal to travel rapidly between

adjacent cells

The conduction system of the heart includes:

• Sinoatrial node
• Atrioventricular node
• Atrioventricular bundle
• Purkenji fibers

https://www.youtube.com/watch?v=TnFoJ7Hhi-M
ELECTROCARDIOGRAMS
( ECG OR EKG)

▪ Actions potentials
conducted through the
heart during the cardiac
cycle procedure electrical
can be measured at the
surface of the body.

▪ Diagram

▪ Useful in evaluating heart

function, a heightened P
wave indicates an
enlarged atrium https://www.youtube.com/watch?
v=ygsvAZVA6sc
▪ ECG- is extremely
valuable tool for
diagnosing a number of
cardiac abnormalities
 CARDIAC CYCLE

❑ Refers to the repetitive pumping process that begins

with the onset cardiac muscle contractions and end
with the beginning of the next contraction

❑ In each cardiac cycle the atria and ventrciles

alternately contract and relax, forcing blood from
areas of high pressure to area of low pressure. As a
chamber of the heart contracts pressure with it
increases
Atrial systole- refers to contraction of the two atria.

Ventricular systole- refers to contraction of the two ventricles.

Atrial diastole- refers to relaxation of two atria, and

Ventricular diastole- refers to relaxation of the two ventricles

 Abnormal Heart Rhythms

 Tachycardia- is a heart rate that's too slow

 Bradycardia-refers to a heart rate that's too fast

 Sinus arrihythmia-abnormal heart rhythms

 Paroxysmal atrial tachycardia-is a type of abnormal heart

rhythm,

 Atrial flutter-is a type of heart rhythm disorder in which

the heart's upper chambers (atria) beat too quickly

 Atrial Fibrillation- is an irregular and often rapid heart

rate that occurs when the two upper chambers of your
hear

 Ventricular tachycardia-
 is a fast, abnormal heart rate. It starts in your heart's lower
chambers, called the ventricles.
 HEARTS SOUNDS

Stethoscope- was originally developed to listen to the

sound of the lungs and heart

There are two main heart sounds

 The first heart sound can be represented by the

syllable lubb
 The second heart can be represented by dupp

 Abnormal heart sounds called murmurs are usually a

result of faulty valves
 Regulation of Stroke Volume

-Stroke volume is determined by sympathetic stimuli making

the myocardial muscle fiber contract with greater strength and
parasympathetic stimuli having the opposite effect.

The factors regulate stroke volume

-Preload: the degree of stretch of heart muscle before it

contacts.

-Contractility: the forcefulness od contraction of individual

muscle fibers.

-Afterload: the resistance to ejection of blood from the

ventricles.
·
 Paroxysmal NOcturnal
Dyspnea

Elevated Pulmonary
capillary Wedge Pressure Restlessness

Pulmonary Congestion
-Cough Orthopnea
-Cracles
-Wheezes
LEFT SIDED HEART FAILURE
-Blood - Tinged
Sputum
-Tacheypnea Tachycardia

Cyanosis
Exertional Dyspnea

Fatigue
Paroxysmal NOcturnal Dyspnea
-Paroxysmal nocturnal dyspnea (PND) causes sudden shortness of breath
during sleep. As a result, you wake up gasping for air. It tends to occur within
a few hours after you’ve fallen asleep.

Restlessness
-Restlessness is feeling the need to constantly move, being unable to calm your
mind, or a combination of the two. People who experience motor restlessness
often feel they have cramps in their arms or legs whenever they're not moving.

Orthopnea
-Orthopnea is the sensation of breathlessness in the recumbent position, relieved by
sitting or standing.

Tachycardia
-is the medical term for a heart rate over 100 beats per minute. There are many heart
rhythm disorders (arrhythmias) that can cause tachycardia. Sometimes, it's normal for
you to have a fast heartbeat.
Exertional Dyspnea
-Shortness of breath during exercise (exertional dyspnea) produces a
sensation of not being able to "get enough air" and a feeling of being
"out of breath." A number of factors can cause exertional dyspnea, but
they are usually related to insufficient tissue oxygenation by the blood.

Fatigue

-Is a term used to describe an overall feeling of tiredness or lack of

energy. It isn’t the same as simply feeling drowsy or sleepy. When you’re
fatigued, you have no motivation and no energy. Being sleepy may be a
symptom of fatigue, but it’s not the same thing.

Cyanosis

- refers to a bluish cast to the skin and mucous membranes. Peripheral

cyanosis is when there is a bluish discoloration to your hands or feet. It's
usually caused by low oxygen levels in the red blood cells or problems
getting oxygenated blood to your body.
Pulmonary congestion
• - is defined as accumulation of fluid in the lungs, resulting in
impaired gas exchange and arterial hypoxemia. It occurs
sequentially, first developing in the hilar region of the lungs,
followed by filling of the interstitial space and finally, in its
most severe form, by alveolar flooding.
Elevated Pulmonary capillary Wedge Pressure

-Pulmonary capillary wedge pressure (PCWP) provides an

indirect estimate of left atrial pressure (LAP). Although left
ventricular pressure can be directly measured by placing a
catheter within the left ventricle, it is not feasible to advance this
catheter back into the left atrium. LAP can be measured by
placing a special catheter into the right atrium then punching
through the interatrial septum; however, for obvious reasons,
this is not usually performed because of damage to the septum
and potential harm to the patient.
·
· Fatigue
The beta-blockers used to treat heart
failure are a common cause.
Deconditioning, depression, poor sleep
and a poor diet can cause fatigue too.
Ascites
- occurs in patients with
increased pressure in the hepatic
veins and in the veins draining
into the peritoneum; it usually
reflects long-standing systemic
venous hypertension. Fever may
be present in severe
decompensated heart failure
because of cutaneous
vasoconstriction and impairment
of heat loss.
· Peripheral venous pressure
pressure - PVP can be particularly
valuable in patients presenting to the
emergency department with shortness of
breath and in cases when jugular venous
examination is limited because of body
habitus, patient positioning, or
practitioner inexperience.
Enlarge of Liver and
Spleen -
An enlarged spleen can be
caused by infections, cirrhosis
and other liver diseases, blood
diseases characterized by
abnormal blood cells, problems
with the lymph system, or other
conditions. Other causes of an
enlarged spleen include:
Inflammatory diseases such as
sarcoidosis, lupus, and
rheumatoid arthritis.
⚫ Distended jugular
veins
Jugular vein distention or JVD is
when the increased pressure of
the superior vena cava causes
the jugular vein to bulge,
making it most visible on the
right side of a person's neck.
Swelling in hands and
fingers/Edema –
Edema is swelling caused by excess
fluid trapped in your body's tissues.
Although edema can affect any part
of your body, you may notice it more
in your hands, arms, feet, ankles and
legs.Edema can be the result of
medication, pregnancy or an
underlying disease often congestive
heart failure, kidney disease or
cirrhosis of the liver.
Anorexia and complaints
of GI Distress
·
-is an eating disorder
characterized by an abnormally
low body weight, an intense fear
of gaining weight and a distorted
perception of weight. People with
anorexia place a high value on
controlling their weight and
shape, using extreme efforts that
tend to significantly interfere with
their lives. Anorexia also includes
emotional and behavioral issues
involving an unrealistic
perception of body weight and an
extremely strong fear of gaining
weight or becoming fat.