cardiac

Happy Nurses Week.

To the student nurses, who are just getting their feet wet and wondering what they’re in for.

For the new grad nurses, whose feet are wet, are still wondering what they’re in for and I’m sorry but what is this on my shoe?

For the experienced nurses, who know better than to look at their shoes any more.

For ortho nurses, who can wrangle anyone into a brace and know how to get you to the bathroom when you’re in a knee immobilizer, a shoulder immobilizer, and two wrist splints.

For cardiac nurses, who can read a rhythm strip from a mile away, are no strangers to pacer pads, and aren’t worried until your run of Vtach hits 20 beats.

For post op nurses, who can identify every drain you know and a few you don’t, who can pop stitches and staples out in 10 seconds without making you flinch, and change a surgical dressing in their sleep.

For med-surg nurses, who will handle the highest ratios and become pros at doling out 120 pills before 9am. 

For renal nurses, OR nurses, emergency nurses, observation nurses, palliative and hospice care nurses, home health nurses, wound nurses, PICC nurses, infusion nurses, clinic nurses, nurse practitioners, nursing professors, oncology nurses, critical care nurses, neuro nurses, and the literal hundreds of other nursing specialties I can’t name.

Thank you for all that you do, and all that you will do.

Anatomy Review: Blood Flow in the Heart

Right Atrium –> Right Ventricle –> Pulmonary Artery –> Lungs –> Left Atrium –> Left Ventricle –> Aorta –> Body

Memory Tip: deoxygenate blood is received on the right-side of the heart, and oxygenated blood leaves from the left-side of the heart. 

Cardiac catheterization is a medical procedure used to diagnose and treat some heart conditions. A long, thin, flexible tube called a catheter is put into a blood vessel in your arm, groin, or neck and threaded to your heart. Through the catheter, your doctor can do diagnostic tests and treatments on your heart.

For example, your doctor may put a special type of dye in the catheter. The dye will flow through your bloodstream to your heart. Then, your doctor will take x-ray pictures of your heart. The dye will make your coronary arteries visible on the pictures. This test is called coronary angiography.

The dye can show whether a waxy substance called plaque has built up inside your coronary arteries. Plaque can narrow or block the arteries and restrict blood flow to your heart. The buildup of plaque in the coronary arteries is called coronary heart disease or coronary artery disease.

Doctors also can use ultrasound during cardiac catheterization to see blockages in the coronary arteries. Ultrasound uses sound waves to create detailed pictures of the heart’s blood vessels. Doctors may take samples of blood and heart muscle during cardiac catheterization or do minor heart surgery.

Cardiologists usually do cardiac catheterization in a hospital. You’re awake during the procedure, and it causes little or no pain. However, you may feel some soreness in the blood vessel where the catheter was inserted. Cardiac catheterization rarely causes serious complications.

(x)

“You can distinguish between Left Bundle Branch Block and Right Bundle Branch Block simply by looking at the QRS morphology in V1 and V6.

If the QRS looks like W in V1 and M in V6 it is LBBB. (WiLLiaM)

If the QRS looks like M in V1 and W in V6 it is RBBB. (MoRRoW)”

Cardiac Structure & Function: A Basic Understanding

In order to better understand cardiac defects, it’s best to start off reviewing how a normal heart works. First, the Superior and Inferior Vena Cava carry deoxygenated blood into the heart (Right Atrium) from other parts of the body. The deoxygenated blood then passes through the Tricuspid Valve into the Right Ventricle. The deoxygenated blood is following the pathway through the heart in order to get to the lungs to gain oxygen, next the blood passes through the Pulmonary Valve and enters the Pulmonary Artery, the pulmonary artery is special because it is the only artery in the body that carries deoxygenated blood. Once the deoxygenated blood passes through to the Lungs it becomes oxygenated. The newly oxygenated blood then flows back to the heart through the Pulmonary Veins and into the Left Atrium. It then passes through the Mitral Valve and into the Left Ventricle. The blood is then contracted through the Aortic Valve into the Aorta and to the rest of the body.


The Fetal Heart:
During the fetal period and some time after birth, the circulation is quite different. The heart has more, holes, if you will in order for the fetal blood to bypass the lungs that are unable to oxygenate blood while the fetus is in utero.
- The Foramen Ovale is an opening that allows passage of blood from the Right Atrium directly into the Left Atrium. The blood passing through is already oxygenated from the placenta. 
- The Ductus Arteriosus is an opening that passes oxygenated blood from the Pulmonary Artery directly into the Aorta to get pumped to the rest of the body.

Normal changes in the heart after birth: 

- Ductus Arteriosus closes
- Foramen Ovale closes
- Ductus Venosus (connection from the umbilical cord) closes

The cardiac cycle is a term referring to all or any of the events related to the flow or blood pressure that occurs from the beginning of one heartbeat to the beginning of the next. The frequency of the cardiac cycle is described by the heart rate. Each beat of the heart involves five major stages. The first two stages, often considered together as the ventricular filling stage, involve the movement of blood from atria into ventricles. The next three stages involve the movement of blood from the ventricles to the pulmonary artery (in the case of the right ventricle) and the aorta (in the case of the left ventricle).

The first, “early diastole,” is when the semilunar valves close, the atrioventricular (AV) valves are open, and the whole heart is relaxed. The second, “atrial systole,” is when the atrium contracts, and blood flows from atrium to the ventricle. The third, “isovolumic ventricular contraction,” is when the ventricles begin to contract, the AV and semilunar valves close, and there is no change in volume. The fourth, “ventricular ejection,” is when the ventricles are empty and contracting, and the semilunar valves are open. During the fifth stage, “Isovolumic ventricular relaxation,” pressure decreases, no blood enters the ventricles, the ventricles stop contracting and begin to relax, and the semilunar valves close due to the pressure of blood in the aorta.