Murmurs Pacemakers

Hypertension ,Angina, CABG ,CCF, DM

MURMURS

Extra, abnormal, or unexpected sound

caused by the flow of blood through the

heart

SYMPTOMS

Chest pain

Rapid or pounding heartbeat

Shortness of breath

Fatigue

Dizziness

Weakness

Fever cough

Paleness

CAUSES

Defective Heart Valve

Holes in the heart wall

Surgical repair of congenital heart defects

Fever

Anemia

PREVENTION

Proper treatments of:

Strep throat

Rheumatic Fever

Hypertension

SIX ATTRIBUTES

Intensity

Pitch

Configuration

Quality

Duration

Timing

INTENSITY/PITCH

Grade I: Faintest, Heard with difficulty

Grade II: Faint but identified immediately

Grade III: Moderately loud

Grade IV: Loud, associated with palpable thrill

Grade V: Very loud

Grade VI: Loudest, can be heard without

stethoscope

CONFIGURATION

Crescendo: increasing

Decrescendo: decreasing

Crescendo-Decrescendo: diamond-

shaped

Plateau: unchanged

QUALITY

Squeaky

Musical

Harsh

Scratchy

Rumbling

Grunting

Blowing

DURATION & TIMING

Length of systole

or diastole a

murmur occupies

Most important

in determining

cause

In relation to

normal cardiac

cycle

TYPES

Diastolic

Muscle relaxation

Systolic

Muscle contraction

Continuous

Throughout cardiac cycle

REFERENCES

http://en.wikipedia.org/wiki/Heart_murmur

http://www.childrenshospital.org/az/site497/m

ainpageS497PO.html

http://heartlink.mcw.edu/article/880000049.ht

ml

http://atoz.iqhealth.com/HealthAnswers/encyc

lopedia/HTMLfiles/3168.html

Pacemakers The study of the heart

Introduction

• Electrical impulses from the heart muscle

cause your heart to beat (contract). This

electrical signal begins in the sinoatrial

(SA) node, atrium). The SA node is

sometimes called the heart’s “natural

pacemaker.”

A pacemaker (or "artificial

pacemaker”)

• so as not to be confused with the heart's natural

pacemaker) is a medical device designed to

regulate the beating of the heart. The purpose

of an artificial pacemaker is to stimulate the

heart when either the heart's native pacemaker

is not fast enough or if there are blocks in the

heart's electrical conduction system preventing

the propagation of electrical impulses from the

native pacemaker to the lower chambers of the

heart, known as the ventricles.

Heart Regulators • Pacemakers are small electrical generators that

control your heart beat. They are often just called pacers. You may need a pacemaker if you have a chronic rhythm problem. The pacemaker is one sealed unit, with a battery, some circuitry, and a connector block inside. The battery supplies the power. The circuitry is like a little computer inside the pacemaker - it changes energy from the battery into tiny electrical pulses that go to your heart through wires called leads. The connector block is plastic, on top of the pacemaker. That's where the leads connect to the generator unit.

Devices that will not affect or

damage pacemakers • CB Radios

• Electric Drills

• Electric Blankets

• Electric Shavers

• Ham Radios

• Heating Pads

• Metal Detectors

• Microwave Ovens

• TV Transmitters

• TV Remote controls

• X-Ray Machines

• Airport Security Detectors

Devices that will affect or damage

the pacemaker

• Power Generating Equipment

• Welding Equipment

• Certain pieces of equipment used by dentists

• Magnetic Resonance imaging (MRI) machines

• Radiation machines for treating cancer

• Heavy equipment or motors that have powerful magnets

Electrocardiogram

• This picture represents the ECG for a normal heart

• Reads the electric pulses in the heart

A pacemaker is about the size of a

matchbox. It is made up of two

parts.

• A pulse generator, which includes the

battery and several electronic circuits

• Wires called leads, which are attached to

the heart wall. Depending on the type of

pacemaker you need, there may be one or

two leads

An X-Ray of a real working

pacemaker looks like this

Pacemaker Patients

• For most people, work, hobbies, sexual

activity, travel, and other aspects of their

lifestyles are no different once they have a

Guidant implanted device. It will help you

enjoy as active and productive a lifestyle

as your overall health permits.

High Blood Pressure

What is high blood pressure?

High blood pressure is when you have a blood reading of 140/80mmHg(millimeters in mercury) or higher.

It is high tension in the arteries.

Also called hypertension.

It does not mean excessive tension or stress.

It is able to cause heart disease, kidney disease, and stroke.

Facts about high blood pressure

One in three Americans has high blood pressure.

It is often called the silent killer because there are no symptoms.

Some people may not find out until they have trouble with their hearts, brains, and kidneys.

If not found and treated

It can cause the heart to become larger, which may lead to heart problems.

Small bulges form on the blood vessels.

Blood vessels in the kidney to narrow.

Arteries in the body to harden.

Blood vessels in the eyes they burst or bleed, which may cause vision changes or blindness.

The types of high blood pressure

Essential hypertension

Secondary hypertension

Essential hypertension

Is a far more common condition and accounts for 95% of hypertension.

It is multilateral in the sense that there are

many causes.

Secondary hypertension

Is 5% of hypertension.

Secondary to a specific abnormality in one or more of the organs.

Treatment

Keep in mind that hypertension occurs way before it does any damage.

Increased public awareness is a good treatment.

Goals

The public awareness is to warn the people of the dangers and the good chance that they might have it.

This is because it is obviously easier to treat it earlier than later.

Sources

www.medicinet.com

www.will-net.com

What Is It?

• Chest pain or discomfort that occurs

when the heart muscle doesn’t get

enough blood.

• Symptom of coronary artery disease.

• The heart doesn’t receive enough

oxygen due to a narrowed coronary

artery.

What Does It Look Like?

• The coronary

artery is narrowed

reducing the flow

of oxygen to the

heart.

• It is easier for

plaque to get

inside a narrower

artery.

What Does It Feel Like?

• May feel like pressure or a squeezing

pain in your chest.

• Pain could also occur in the

shoulders, arms, neck, jaw, or back.

• Could also feel like indigestion.

Types of Angina

• Stable Angina

• Unstable Angina

• Variant Angina

Stable Angina

• Most common type of angina.

• Occurs when the heart is working

harder than usual.

• Regular pattern.

• Pain goes away a few minutes after

resting or taking medicine.

• Makes it more likely to have a heart

attack in the future.

Unstable Angina

• Very dangerous condition that

requires emergency treatment.

• Could be a sign that heart attack

might occur soon.

• Does not follow a pattern.

• Can occur without physical exertion.

• Not relieved by rest or medicine.

Variant Angina

• Very rare.

• Usually occurs when one is at rest

between midnight and in the early

morning.

• Pain can be severe.

• Relieved by medicine.

Treatments

• Do It Yourself Treatments

• Control high blood

pressure

• Quit smoking

• Control cholesterol

levels

• Control weight

• Physical activity

• Regular exercise

which must be

ensured by a doctor

that it will not trigger

angina.

• Control diabetes

• Avoid stress

• Avoid getting cold

• Avoid excessive

alcohol

More Treatments

• Medications

• Nitroglycerin

• Glycerin Trinitrate

Tablets

• Beta Blockers

• Calcium and Channel

Blockers

• Surgery

• Coronary Artery

Bypass Surgery

• Balloon Angioplasty

• Artery Stent

Sources

• http://www.wrongdiagnosis.com/a/an

gina/treatments.htm

• http://www.nhlbi.nih.gov/health/dci/

Diseases/Angina/Angina_WhatIs.html

• http://www.umm.edu/patiented/graph

ics/images/en/18054.jpg

Heart Attack

Definition • Heart attack (myocardial

infarction) is a medical emergency in which some of the heart’s blood supply is suddenly and severely reduced or cut off, causing the heart muscle (myocardium) to die because it is deprived of its oxygen supply.

Symptoms

• chest pain or discomfort in the center of the chest, “heaviness” or “crushing” feeling that lasts for more than a few minutes or goes away and comes back

• pain or discomfort in other areas of the upper body including arms, back, neck, jaw, or stomach

More Symptoms • difficulty breathing, shortness of

breath • sweating or “cold sweat” • fullness, indigestion, or choking feeling

(may feel like “heartburn”) • nausea or vomiting • light-headedness • extreme weakness or anxiety • rapid or irregular heart beats

Causes

• usually occurs when a blockage in a coronary artery reduces or cuts off the blood supply to an area of the heart

• a blood clot is the most common cause of a blocked coronary artery

More Causes • uncommonly, a heart attack results

when a clot forms in the heart itself, breaks away, and lodges in a coronary artery

Complications • A person who has a heart attack

may experience any of the following complications: Myocardial Rupture, Scar Tissue, Ventricular Aneurysm, Blood Clots, and Heart Failure.

Rehabilitation • Cardiac rehabilitation, an important

part of recovery, begins at the hospital.

• people who have had a heart attack can usually progress to sitting in a chair, passive exercise, use of a commode chair, and reading on the first day.

More Rehabilitation • By the second or third day,

people are encouraged to walk to the bathroom and engage in nonstressful activities, and they can perform more activities each day.

Getting Back on Track • Most people can return to work and the

activities they enjoy within a few weeks of having a heart attack.

• For the first few days after your heart attack, you may need to rest and let your heart heal.

• You may do stretching exercises and get up and walk.

Risk Factors for Another Heart Attack

• not exercising • being overweight • high cholesterol level • high blood sugar level if you have

diabetes • high blood pressure • smoking • too much stress in your life

References • http://www.clevelandclinic.org/hear

tcenter/pub/guide/disease/cad/mi_symptoms.htm

• http://www.merck.com/mmhe/print/sec03/ch033/ch033c.html

• http://www.familydoctor.org.xml

Coronary Bypass Surgery

What is coronary artery bypass surgery?

type of heart surgery

reroutes, ”bypasses” blood around clogged arteries

improves blood flow and oxygen flow to the heart

Why is bypass needed?

Coronary arteries (the arteries that carry blood to the heart) can become clogged

clogging is caused by plaque (fat, cholesterol, and other substances)

buildup hinders blood flow through vessels

lack of blood flow can cause chest pain and or a heart attack

How is coronary bypass done?

segment of healthy blood vessel is taken from leg to reroute blood through heart

one end of the vein is sewn onto the aorta and the other is grafted below the blockage on the coronary artery

patients can undergo one, two, three or more bypasses depending on the extent of the damage

Portion of saphenous vein

is used to bypass blood through

the heart.

After surgery…

Patients’ blood pressures and heart activity are monitored for three to five days

Patients are given pain killers to keep them comfortable

Tests are done to evaluate patient’s condition

A healthy diet and exercise plan are recommended

Side Effects

loss of appetite

constipation

swelling

fatigue

depression

difficulty sleeping

muscle pain or tightness

Alternatives to Bypass

Medications

Stent

o a wire mesh tube used to prop open an artery

Angioplasty

o a tiny balloon is inserted into the blocked blood vessel and inflated to widen the opening

Facts

Woman have a higher mortality rate than men with coronary bypass surgery

About 7 million Americans suffer from Coronary Heart Disease.

Heart Disease is the number one killer of men and women in the U.S. each year

500,000 Americans die of heart attacks caused by CHD (Coronary Heart Disease).

normal heart

blockage occurs

heart becomes deprived of blood

saphenous vein used to bypass blockage

vein graft restores normal blood flow to heart

Works Cited

http://www.americanheart.org/presenter.jhtml?identifier=4484

adam.about.com/ surgery/100190.htm

www.americanheart.org

Google images

Congestive heart failure (CHF), is a condition in which the heart can't pump

enough blood to the body's other organs.

•Narrowed arteries that supply blood to

the heart muscle — coronary artery

disease.

•Past heart attack, with scar tissue that

interferes with the heart muscle's

normal work.

•High blood pressure.

•*&* many more…

•Frequent bathroom usage.

•Tired and weak.

•Weight gain from excess fluid.

•Chest pain.

•Swollen feet, legs, and/or ankles.

•Loss of appetite.

•Swollen neck veins.

•Skin is cold and sweaty.

•Pulse is irregular.

Most doctors can make a tentative

diagnosis of CHF from the presence of

edema(accumulation of fluid) and

shortness of breath.

•Crackling sounds of fluid in the lungs can

be heard with a stethoscope.

•A chest x-ray can show if your heart is

enlarged.

•If you smoke, quit.

•Learn to control high blood pressure,

cholesterol levels, and diabetes.

•Eat a sensible diet that is low in calories,

saturated fat, and salt.

•Limit how much alcohol you drink.

•Weigh yourself daily to watch for fluid

buildup.

•Vasodilators, such as nitroglycerin,

which open up narrowed vessels.

•Calcium channel blockers, which keep

vessels open and lower blood pressure.

•ACE inhibitors, which keep vessels

open and lower blood pressure.

•Heart valve repair or replacement

•Pacemaker insertion

•Correction of congenital heart defects

•Coronary artery bypass surgery

•Mechanical assist devices

•Heart transplant

•The heart weakens and can lead to

death.

•http://www.americanheart.org

•http://www.texasheartinstitute.org

•http://www.mayoclinic.com

•http://en.wikipedia.org

Diabetes is when your pancreas does not

produce enough insulin for your body. It is

a leading factor in developing heart

disease.

♥ Increased thirst

♥ Extreme hunger

♥ Rapid weight loss

♥ Blurred Vision

♥ Fatigue

♥ Genetics ♥ Not eating right ♥ Exposure to certain viruses

Family History

Race

♥

♥

* Random blood sugar tests

* Fasting blood glucose tests

Low Blood Sugar

*&*

Increased Blood

Acids

* Cardiovascular disease

* Nerve damage

* Kidney damage

* Eye damage

* Skin conditions

Blood Sugar Monitoring

Eating Right

Exercising

Medications

Pancreas Transplants

Islet Cell Transplants

Make a commitment to manage

your diabetes

Yearly Physical

Have needed vaccinations

Take care of your feet

Don’t smoke

Avoid alcohol

Take aspirin daily

Monitor your blood pressure

Monitor blood fats

Learn to manage stress

http://www.mayoclinic.com

http://www.uab.edu

http://www.diabetes.com

http://www.lifeclinic.com