Nursing Care of

Physiologic Disorders
of the Cardiovascular
Function
MA.HANNY A. DELA CRUZ
Contents
Here’s what you’ll learn in this presentation:
 Overview of the Anatomy and Physiology of the Cardiovascular System
 Age-Related Changes in Structure and Function
 Common Cardiovascular Problems in older adults
HEART FAILURE
ATHEROSCLEROSIS
ARRTYTHMIAS
HYPERTENSION
 Anatomy and
Physiology of the
Cardiovascular System
Overview
Introduction
The Cardiovascular System
A closed system of the heart and blood
vessels
 The heart pumps blood
 Blood vessels allow blood to circulate
to all parts of the body

FUNCTIONS
 Transport oxygen and Carbon Dioxide to and from the
tissues
 Transports nutrients, waste products and hormones
 Regulates body temperature
 Plays role in the immune response
T  located in
H the
thoracic cavity
E between the
two
pleural
cavities that
surround the
lungs
H
 surrounded
E by its
own cavity,
A the
pericardial
R cavity

T
Terms to Remember!
Internal Anatomy of the Heart
● Pericardium - acts as mechanical
protection for the heart and big
vessels, and a lubrication to reduce
friction between the heart and the
surrounding structures.
● Epicardium – outer protective layer
● Myocardium – muscular middle
layer
● Endocardium – inner layer
Terms to Remember
External Anatomy of the Heart
● Superior/Inferior Vena Cava – carry
blood from body to right atrium
● Pulmonary Veins – carry blood from
lungs to left atrium
● Pulmonary Arteries – carry blood
from heart to the lungs
● Aorta – carry blood from the heart to
the rest of the body
Terms to Remember
Heart Chambers
● Atria – 2 upper chambers; receives
blood from the veins; contraction of
atria forces blood into ventricles
● Ventricle – 2 lower chambers; pump
out blood out of the heart into
arteries; left is thicker than right
Septum – separates heart into right and
left
Terms to Remember
Heart Valves
● Tricuspid valve
● Bicuspid valve
● Aortic Semilunar valve
● Pulmonary Semilunar valve

Function: to prevent backflow

Terms to Remember
Conduction System of the Heart
● Sinoatrial (SA) node
– cluster of cells in wall of Rt. Atria
-begins heart activity that spreads to both atria
-excitation spreads to AV nodes
● Atrioventricular (AV) node
-in atrial septum, transmits signal to bundle of His
● AV bundle of His
-the connection between atria and ventricles
-divides into bundle branches and Purkinje fibers, large
diameter fibers that conduct signals quickly
Important Facts
 The heart of a healthy adult, at rest, pumps
approximately 5 liters (L) of blood per
minute.
 The heart continues to pump at
approximately that rate for more than 75
years.
 During vigorous exercise, the amount of
blood pumped out of the heart per minutes
drastically increases.
Important Facts
 If the heart stops contracting, blood flow
throughout the body stops.

 If the heart stops functioning for a few

minutes life will end

 The heart is actually two pumps in one.

 Right side- Pulmonary Circulation
 Left side- Systemic Circulation
BLOOD CIRCULATION
AGE-RELATED CHANGES IN STRUCTURE AND
FUNCTION

Aging alters the cardiovascular

system both structurally and
physiologically.
Increasing evidence suggests that
life-style and diet may modify some
of these age related changes
(Aronow, 2015; Khan et al., 2013;
Yancy 2017)
 AGE-RELATED CHANGES IN STRUCTURE AND
FUNCTION
 Conduction System
A
● Sinoatrial (SA) and Atrioventricular (AV)
and the bundle of His become fibrotic with
B age
● Number of pacemaker (send electrical
pulses to help your heart beat at a normal
rate and rhythm) in the SA decreases with
age
A) Normal ● Common aging changes reflected by
B) Abnormal electrocardiography (ECG)
 AGE-RELATED CHANGES IN STRUCTURE AND
FUNCTION
 Blood Vessels
● Calcification [the process of
calcium build up] of vessels, Normal
making them tortuous [twisted].
● Elastin in vessel wall decreases
causes thickening and rigidity
especially in coronary arteries
leading to increased risk of
atherosclerotic build up. Artery
● Loss of arterial elasticity in older with
adults leads to increased systolic plaque
build-
blood pressure (SBP)
up
AGE-RELATED CHANGES IN STRUCTURE AND
FUNCTION

 Response to Stress
Decreased cardiac output and reserve
diminish the older adult’s response to
stress. Reduced stress response to
stress plus the changes in the heart
and vessels affects the body’s reaction
to exercise. During stress stimulation,
the heart rate increases more slowly;
however once elevated slightly; it
takes longer to return to resting rate
(Banasik, 2013b)
 COMMON
CARDIOVASCULAR
PROBLEMS
00 Introduction
Heart disease is the leading cause of
death in the US and is a major cause of
disability.
Coronary Heart Disease (CAD) is the
principal type of heart disease. According
to the Centers for Disease Control and
Prevention (CDC), more than 800,000
people die of heart disease in the US
each year, which is about 30% of all US
deaths (Benjamin et al., 2017).
Introduction Risk factors for cardiovascular disease (CVD)
include elevated cholesterol, hypertension
(HTN), diabetes mellitus, tobacco use, physical
inactivity, obesity, alcohol use, advancing age,
and heredity.

As individuals age, the chance of comorbid

conditions increases. Atherosclerosis, the
underlying cause of most clinical cardiovascular
problems, is typically present for years before
the onset of a clinical event such as heart
attack, or symptoms such as angina manifest
(Benjamin et, al. 2017).
HEART Chronic heart failure is a disease of “old old” people

FAILURE clinical syndrome caused by structural and/or functional

cardiac abnormalities, resulting in a reduced cardiac output
and/or elevated intracardiac filling pressures at rest or during
stress.

Heart Failure represents the leading cause of hospitalization

in patients older than 65 years in Western countries.

Patients may present with confusion, depression, fatigue,

weight loss, immobility or “social crisis”.
HEART Patients with chronic heart failure caused by systolic

FAILURE dysfunction tend to present with gradual worsening of

daytime symptoms and paroxysmal nocturnal dyspnea,
whereas those with diastolic dysfunction may present with a
more abrupt onset of symptoms
ATHEROSCLER
Atherosclerosis is classed as a disease of aging,
OSIS such that increasing age is an independent risk
factor for the development of atherosclerosis.
ARRTYTHMI
Patients ≥80 years of age have significant
AS structural and electrical remodeling of cardiac
tissue; accrue competing comorbidities; react
differently to drug therapy; and may
experience falls, frailty, and cognitive
impairment, presenting significant therapeutic
challenges.
HYPERTENSI
The prevalence of arterial hypertension is
ON constantly rising, mainly as the result of the
aging of the population, in particular, the
increase in the population over 80 years old,
which has expanded exponentially over the
past 40 years.
Risk Factors for Heart Disease
 Diet
 Smoking
 Physical Activity
 Obesity
 Diabetes
 Stress
 Menopause