Cardiovascular

and Circulatory
Function
 Heart Chambers
• Diastole
• the relaxation phase,, all four chambers relax simultaneously, which
allows the ventricles to fill in preparation for contraction.
• commonly referred to as the period of ventricular filling
• repolarization
• Systole
• refers to the events in the heart during contraction of the atria and
the ventricles
• depolarization
Anatomy of the
Heart
Cardiac Action Potential
Cardiac conduction system
 Cardiac Conduction System and Understanding ECG

• https://www.youtube.com/watch?v=RYZ4daFwMa8
Normal Heart Sound
 Diagnostic Evaluation
Cardiac Biomarker Analysis

• Myocardial cells that become necrotic from prolonged ischemia or

trauma release specific enzymes
• (creatine kinase [CK]),
• CK isoenzymes (CK-MB),
• proteins (myoglobin, troponin T, and troponin I)
 C
• https://www.youtube.com/watch?v=_qmNCJxpsr0
 C
• https://www.youtube.com/watch?v=_qmNCJxpsr0
Chest X-Ray and Fluoroscopy
• chest x-ray is obtained to determine the size, contour, and position of
the heart
• It reveals cardiac and pericardial calcifications and demonstrates
physiologic alterations in the pulmonary circulation
• Correct placement of pacemakers and pulmonary artery catheters

Electrocardiography
a graphic representation of the electrical currents of the heart
12 Lead ECG
Placement
ECG
• diagnose dysrhythmias, conduction
abnormalities, and chamber
enlargement, as well as myocardial
ischemia, injury, or infarction

• suggest cardiac effects of electrolyte

disturbances (high or low calcium and
potassium levels) and the effects of
antiarrhythmic medications
Cardiac Stress Testing
 Nursing Interventions
• In preparation for the exercise stress test, the patient is instructed to
fast for at least 3 hours before the test and to avoid stimulants such as
tobacco and caffeine.
• Medications may be taken with sips of water.
• The primary provider may instruct the patient not to take certain
cardiac medications, such as beta-adrenergic blocking agents, before
the test.
• Clothes and sneakers or rubber-soled shoes suitable for exercising are
to be worn
Myocardial
Perfusion
Imaging
• commonly performed after
an acute MI to determine if
arterial perfusion to the
heart is compromised during
activity and to evaluate the
extent of myocardial
damage. It is also used to
evaluate if myocardial
ischemia from CAD is the
cause of chest pain or other
CAD-related symptoms.
 Nursing Interventions
• primary role is to prepare the patient for SPECT and insert an IV
catheter or assess an existing IV for patency and suitability

• The IV is used to inject the tracer

• instructs the patient to refrain from using alcohol and caffeine for 24
hours before undergoing PET because of the stimulating effects they
may have on the heart
• The nurse assesses patients for fear of closed spaces or
claustrophobia
 Cardiac Catheterization
• Instructing the patient to fast, usually for 8 to 12 hours, before the
procedure
• performed as an outpatient procedure, a friend, family member, or other
responsible person must transport the patient home
• expected duration of the procedure and advising that it will involve lying
on a hard table for less than 2 hours
• Reassuring the patient that IV medications are given to maintain comfort
• sensations that will be experienced during the catheterization.
• Encouraging the patient to express fears and anxieties
• Instructing the patient to report chest pain and bleeding or sudden
discomfort from the catheter insertion sites promptly
• Ensuring patient safety
Central Venous
Pressure Monitoring
-used in critical care for
assessing left ventricular
function, diagnosing the etiology
of shock, and evaluating the
patient’s response to medical
interventions (e.g., fluid
administration, vasoactive
medications)
Pulmonary
Catheter
Central Venous Pressure
Monitoring
• CVP is a measurement of the
pressure in the vena cava or right
atrium. The pressure in the vena
cava, right atrium, and right
ventricle are equal at the end of
diastole; thus, the CVP also
reflects the filling pressure of the
right ventricle (preload)
Pacemaker Therapy
• may be used to treat
advanced heart failure
• permanent or temporary.
• Temporary pacemakers are
used to support patients until
they improve or receive a
permanent pacemaker (e.g.,
after acute MI or during open
heart surgery)
 Implantable Cardioverter Defibrillator
• an electronic device that detects and
terminates life-threatening episodes of
tachycardia or fibrillation
• ventricular in origin.
• Patients at high risk of VT or ventricular
fibrillation and who would benefit from an
ICD are those who have survived sudden
cardiac death syndrome, which usually is
caused by ventricular fibrillation, or have
experienced spontaneous, symptomatic VT
(syncope secondary to VT) not due to a
reversible cause (called a secondary
prevention intervention)
Cardioverter
Defibrillator
 Educating the Patient With an Implantable Cardiac Device
• Electromagnetic interference: Understand the importance of the following:
• Avoid large magnetic fields, such as those created by magnetic resonance imaging,
large motors, arc welding, and electrical substations.
• Magnetic fields may deactivate the device, negating its effect on a dysrhythmia. At
security gates at airports, government buildings, or other secured areas, show
identification card and request a hand (not handheld device) search.
• Obtain and carry a letter from the primary provider about this requirement.
• Some electrical and small motor devices, as well as products that contain magnets
(e.g., cellular phones), may interfere with the functioning of the cardiac device if the
electrical device is placed very close to it.
• Avoid leaning directly over large electrical devices or motors, or ensure that contact
is of brief duration; place cellular phone on opposite side of cardiac device.
• Household appliances (e.g., microwave ovens) should not cause any concern.