Cardiacphysiology&anaestheticconsiderationscardiacoutput,pulse,bp,cardiacindex,coronarycirculation
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Cardiacphysiology&anaestheticconsiderationscardiacoutput,pulse,bp,cardiacindex,coronarycirculation
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Cardiacphysiology&anaestheticconsiderationscardiacoutput,pulse,bp,cardiacindex,coronarycirculation
- 1. CARDIAC PHYSIOLOGY & ANAESTHETIC CONSIDERATIONS By- Dr. Armaan Singh
- 2. Heart Hollow Located within the mediastinum of the thorax Distal end extends downward to the left forming apex at the fifth intercostal space. By-Dr.ArmaanSingh
- 3. HEART STRUCTURE ANATOMICALLY ONE ORGAN FUNCTIONALLY DIVIDE INTO RT. & LT PUMPS FOUR VALVES WITH UNIDIRECTIONAL FLOW By-Dr.ArmaanSingh
- 6. By-Dr.ArmaanSingh The heart consists of three different layers
- 8. Coronary supply Inferior Rt coronary Anteroseptal Lt ant descening Anteroapical Lt ant desceding( distal) Anterolateral Circumflex Posterior Rt coronary artery By- Dr. Armaan Singh
- 10. By-Dr.ArmaanSingh MEMBRANEPOTENTIAL(mV) -90 0 0 1 2 3 4 TIME PHASE 0 = Rapid Depolarization (inward Na+ current) 1 = Overshoot 2 = Plateau (inward Ca++ current) 3 = Repolarization (outward K+ current) 4 = Resting Potential Mechanical Response
- 11. PACEMAKERS (in order of their inherent rhythm) • Sino-atrial (SA) node • Atrio-ventricular (AV) node • Bundle of His • Bundle branches • Purkinje fibers By-Dr.ArmaanSingh
- 12. By-Dr.ArmaanSingh AtrioVentricular Node Sinoatrial Node Atrioventricular Bundle Purkinje Fibers Heart Conduction System
- 13. INITIATION & CONDUCTION OF THE CARDIAC IMPULSE By-Dr.ArmaanSingh
- 14. Heart Actions • Atrial systole is when the atria contract while the ventricles relax which is called ventricular diastole. • Thus systolic and diastolic blood pressure. • This series of contraction and relaxation is called a cardiac cycle. By-Dr.ArmaanSingh
- 15. By-Dr.ArmaanSingh LATE DIASTOLE ATRIAL SYSTOLE ISOMETRIC VENTRICULAR CONTRACTION VENTRICULAR EJECTION ISOMETRIC VENTRICULAR RELAXATION EVENTS IN CARDIAC CYCLE DIASTOLE
- 17. CARDIAC OUTPUT • DEFIND AS VOLUME OF BLOOD PUMPED BY HEART/MIN • CO = SV X HR • SV IS VOLUME PUMPED PER CONTRACTION • average cardiac output would be 5L.min-1 for a human male and 4.5L.min-1 for a female. By-Dr.ArmaanSingh
- 18. CARDIAC OUTPUT AND THE FICK PRINCIPLE By-Dr.ArmaanSingh BODY O2 CONSUMPTION 250mlO2/min PaO2 190mlO2/l blood PvO2 140mlO2/l blood PULMONARY ARTERY PULMONARY VEIN CARDIAC OUTPUT= O2 CONSUMPTION (ml/min) PaO2 - PvO2 Pulmonary capillaries Lungs
- 19. Pulse • Pressure wave move along the artery wall which are pliable • usually measured in beats per minute • normal range from 60 to 100 beats per minute By-Dr.ArmaanSingh
- 20. Factors Influencing the Pulse • Stroke volume • Rate of ejection • Distensibility of peripheral arteries • Peripheral resistance • Pulse rate • Pulse pressure • Size of the vessel • Distance from the heart By-Dr.ArmaanSingh
- 21. Pulsus Parvus • The pressure is diminished, and the pulse feels weak and small, seen in - restrictive pericardial disease, hypovolemia, mitral stenosis • Pulsus Parvus et Tardus (weak and delayed): →Aortic Stenosis By-Dr.ArmaanSingh
- 22. Bisferiens Pulse • Increased arterial pulse with a double systolic peak. • Causes : AR • HCM By-Dr.ArmaanSingh
- 23. Bigeminal Pulse • characterized by groups of two heartbeats close together followed by a longer pause. The second pulse is weaker than the first • Causes: severe HF, hypovolemic shock, cardiac tamponade) By-Dr.ArmaanSingh
- 24. Pulsus Alternans arterial pulse waveform showing alternating strong and weak beats • Causes: • Left ventricular failure • severe AR By-Dr.ArmaanSingh
- 25. Pulsus Paradoxus • Pressure drop > 20 mmHg during inspiration. • Normally, systolic arterial pressure falls 8-12 mmHg during inspiration. • Causes: • Cardiac Tamponade • COPD, hypovolemic shock By-Dr.ArmaanSingh
- 26. BLOOD PRESSURE • DEFINE AS PRESSURE OF BLOOD AGAINST THE WALL OF MAIN ARTRIES • HIGHEST DURING SYSTOLE N LOWEST DURING DIASTOLE • MEASURED BY SPHYGMOMANOMETER @ BRACHIAL ARTERY OF ARM By-Dr.ArmaanSingh
- 27. Blood Pressure (BP): Measurements By-Dr.ArmaanSingh Figure 15-7: Measurement of arterial blood pressure
- 28. CLASSIFICATION Category Systolic Diastolic hypotension <90 <60 normal 90 – 119 60 - 79 prehypertes ion 120 - 139 80 - 89 stage1ht 140 - 159 90 - 99 stage2ht >160 >100 By- Dr. Armaan Singh
- 29. Pulse and Mean Arterial Pressures • Pulse pressure = Systolic –Diastolic • Mean arterial pressure (MAP) = Diastolic + 1/3 pulse pressure By-Dr.ArmaanSingh
- 33. EJECTION FRACTION • Ejection fraction (Ef) is the fraction of the end-diastolic volume that is ejected with each beat • it is stroke volume (SV) divided by end-diastolic volume (EDV): By-Dr.ArmaanSingh
- 34. EJECTION FRACTION • In a healthy man, the SV is approximately 70 ml and the left ventricular EDV is 120 ml, giving an ejection fraction of 70/120, or 0.58 (58%). • Healthy individuals typically have ejection fractions between 50% and 65% By-Dr.ArmaanSingh
- 35. METHODS OF EF MEASUREMENT • CARDIAC CATHETRISATION • RADIONUCLEOTIDE STUDIES • ANGIOCARDIOGRAPHY By-Dr.ArmaanSingh
- 36. CARDIAC INDEX • Cardiac index (CI) is a vasodynamic parameter that relates the cardiac output to body surface area • unit of measurement is (l/min/m2) • normal range of cardiac index is 2.6 - 4.2 L/min per square meter. By-Dr.ArmaanSingh
- 37. ANAESTHETIC CONSIDERATION• Halothaane isoflurane and enflurane depress SA node automaticity. • IV induction agent have limited effect on usual clinical doses. • Opioids can depress cardiac conduction. • LA associated with systemic toxicity. By-Dr.ArmaanSingh
- 38. GOALS OF ANAESTHESIA IN CVS DISEASES • PREMEDICATE BY BZP’S • BLUNT RESPONSE BY LARYGOSCOPY N INTUBATION • AVOID TACHYCARDIA • AVOID HYPOCAPNIA By-Dr.ArmaanSingh
- 40. By-Dr.ArmaanSingh FOR MORE MEDICAL PRESENTATIONS VISIT Slideshare/Dr. Armaan Singh
Hinweis der Redaktion
- Features of the heart especially the systemic and pulmonary blood vessels chambers and valves.