Cardiovascular System

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Functions
Bodys delivery service Heart:
Pumps blood through the body

Blood Vessels:
Carry oxygen-rich blood to all the bodys cells and return deoxygenated blood to the heart

The Heart
Average adult heart- fist-sized
Lies in thoracic cavity, between the lungs Two-thirds of the heart actually lies to the left of the sternum

Amazingly powerful muscle

Beats an average of 72 times per minute, 100,000 times a day and 3000 million times (3 trillion) in the average lifetime

Parts of the Heart

The Pericardium:
A protective sac that covers the heart Has two layers:
Visceral pericardium: innermost layer next to the heart Parietal pericardium: outer layer

Parts of the Heart

The Heart:
Three layers of tissue:
Epicardium: outer layer Myocardium: middle layer, muscular tissue Endocardium: inner layer, forms membrane lining the chambers and valves

The Heart
The heart is divided into right and left sides Each side has two chambers Right Side:
Right Atrium: upper chamber Right Ventricle: lower chamber

Left Side: same as right Two sides are separated from each other by a partition called the septum

The Heart
Valves of the Heart: Control blood flow to and from the heart Valves that control blood between atria and ventricles:
Bicuspid (mitral) valve: Valve between left atrium and ventricle Tricuspid valve: Between right atrium and ventricle

Valves that control blood leaving the heart (preventing backflow): Pulmonary and Aortic Valves

Blood Flow

Blood Flow Animation

Blood flows through the chambers of the heart in only one direction The flow is regulated by the valves of the heart Arteries: carry blood AWAY from the heart
Usually carry blood rich in oxygen EXCEPTION: Pulmonary Artery, which carries blood low in oxygen AWAY from the heart, toward the LUNGS to pick up OXYGEN from the ALVEOLI

Blood Flow
Veins: carry blood TOWARD the heart
Usually carry blood low in oxygen EXCEPTION: Pulmonary Veins, which returns blood that is rich in oxygen TOWARD the heart. This blood is coming from the lungs

Cardiac Conduction System

The heart muscle works like a pump. Electrical impulses control the pumping cycle of the heart muscle. Electrical impulses begin in one part of the heart and travel all through the heart. The special tissues in the heart that produce electrical impulses form the cardiac conduction system

Cardiac Conduction System The Cardiac Conduction System contains:

The Sinoatrial (SA) node The Atrioventricluar (AV) node Bundle of His (AV Bundle) Bundle Branches Purkinje Fibers (network)

SA Node
Small round structure Located in upper part of right atrium Natural pacemaker-makes the heart start to beat Fires at about 60-100 times per minute
Fire: transmit a nervous impulse or electrical signal

Conduction begins in the SA node (which

means that each heartbeat begins here as well)

AV Node
Also small and round structure Located along the floor of the right atrium Receives impulses traveling through the heart (from the SA node) and can delay or slow down the impulse If SA node is not working, AV node can also act as the pacemaker Usually fires at a rate of 40-60 times per minute

Bundle of His
Located next to the AV node Transfers electrical energy from the atria to the ventricles When impulses reach the ventricles, they are divided into the bundle branches

Bundle Branches
Located along the left and right side of the septum separating the left and right ventricles Impulses travel through the left and right bundle branches to the left and right ventricles Fork in the Road: Some impulses go right, others left Make the heart muscle contract

Purkinje Network
Spreads the impulses throughout the ventricles, through a system of fibers called the Purkinje fibers Fibers provide an electrical pathway for each of the cardiac cells Electrical impulses speed up here
Activate right and left ventricles at one time, causing them to contract Electrical impulse produces an electrical wave, which can be recorded using an Electrocardiogram (ECG)

Circulation
There are three types of circulation:
Coronary Pulmonary Systemic

Coronary Circulation
Circulation of blood within the heart Coronary Arteries: branch off the aorta to supply blood to the heart muscle AORTA: main artery through which blood exits the heart Fun Fact: the heart needs more oxygen to function than any other organ (except the brain)

Pulmonary Circulation
Flow of blood between the heart and the lungs Pulmonary arteries: carry blood LOW in oxygen from the right ventricle of the heart to the lungs, where it will pick up oxygen from the alveoli Blood RICH in oxygen flows back to the left atrium through vessels called the Pulmonary veins

Systemic Circulation
Flow of blood between the heart and the cells of the body The heart pumps blood through the arteries to the cells of the body The muscular contraction of the heart pushes the blood through the arteries Blood going from the heart to the cells of the body is RICH in oxygen

Special Arteries
Specialized arteries are those that carry oxygen-rich blood to specific areas of the body Carotid Artery: supplies blood to the head and neck Femoral artery: supplies blood to the thigh Arterioles: smaller divisions of arteries Capillaries: smallest blood vessel
Deliver nutrients and oxygen to cells Remove waste products from cells

Systemic Circulation
After flowing through the capillaries, blood begins the trip back to the heart through venules, which are small veins The Veins take blood that is LOW in oxygen back to the heart

Systemic Circulation
The blood from the upper part of the body is collected and returns to the heart through the Superior Vena Cava Blood from the lower part of the body collects and returns to the heart through the Inferior Vena Cava Both vessels return blood to the Right Atrium

Diseases of the Cardiovascular System

Hypertension Stroke Aneurysm Coronary Artery Disease (CAD) Myocardial Infarction (MI, Heart Attack) Congestive Heart Failure (CHF)

Congestive Heart Failure (CHF)

Occurs when heart cannot pump at its usual capacity Vital organs do not receive enough blood May occur as a result of atherosclerosis and/or MI

Congestive Heart Failure (CHF)

Heart is weakened and cannot pump at its usual force If the right side of the heart is weakened, blood backs up in the lungs and builds up If left side of heart is weakened, blood builds up in heart tissue

 Congestive heart failure (CHF) is a common clinical disorder that results in pulmonary vascular congestion and reduced cardiac output. CHF should be considered in the differential diagnosis of any adult patient who presents with dyspnea and/or respiratory failure. The diagnosis of heart failure is often determined by a careful history and physical examination and characteristic chestradiograph findings. The measurement of serum brain natriuretic peptide and echocardiography have substantially improved the accuracy of diagnosis. Therapy for CHF is directed at restoring normal cardiopulmonary physiology and reducing the hyperadrenergic state. The cornerstone of treatment is a combination of an angiotensin-converting-enzyme inhibitor and slow titration of a blocker. Patients with CHF are prone to pulmonary complications, including obstructive sleep apnea, pulmonary edema, and pleural effusions. Continuous positive airway pressure and noninvasive positive-pressure

Symptoms Heart failure can be chronic meaning your condition is ongoing or acute, meaning your condition has started suddenly.

Chronic heart failure symptoms

Shortness of breath (dyspnea) when you exert yourself or when you lie down Fatigue and weakness Swelling (edema) in your legs, ankles and feet Rapid or irregular heartbeat Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Swelling of your abdomen (ascites) Sudden weight gain from fluid retention Lack of appetite and nausea Difficulty concentrating or decreased alertness

Acute heart failure symptoms

Symptoms similar to those of chronic heart failure, but more severe and start or worsen suddenly Sudden fluid buildup Rapid or irregular heartbeat (palpitations) Sudden, severe shortness of breath and coughing up pink, foamy mucus Chest pain, if your heart failure is caused by a heart attack

When to see a doctor

See your doctor if you experience any of the signs or symptoms associated with heart failure. These include: Chest pain Fatigue and weakness Rapid or irregular heartbeat Shortness of breath (dyspnea) when you exert yourself or when you lie down Reduced ability to exercise Persistent cough or wheezing with white or pink blood-tinged phlegm Swelling in your abdomen, legs, ankles and feet

 Difficulty concentrating or decreased alertness You may first find out you have heart failure from an emergency room visit after worsening symptoms. Other heart and lung problems can cause symptoms that are similar to heart failure. If you have a diagnosis of heart failure, and if any of the symptoms suddenly become worse or you develop a new sign or symptom, it may mean that existing heart failure is getting worse or not responding to treatment. Contact your doctor promptly.

Causes
Heart failure often develops after other conditions have damaged or weakened your heart. Over time, the heart can no longer keep up with the normal demands placed on it to pump blood to the rest of your body. The main pumping chambers of your heart (the ventricles) may become stiff and not fill properly between beats. Also, your heart muscle may weaken, and the ventricles stretch (dilate) to the point that the heart can't pump blood efficiently throughout your body. The term "congestive heart failure" comes from blood backing up into or congesting the liver, abdomen, lower extremities and lungs. Heart failure can involve the left side, right side or both sides of your heart. Typically, heart failure begins with the left side specifically the left ventricle, your heart's main pumping chamber.