Hamad at the Cooperative

Hamad at the Cooperative

1. Cardiovascular diseases

   • Anatomy of the heart
     • Atria
       • right
         • The interior surface can be divided into two parts, separated by a muscular ridge called the crista terminalis:
           • Sinus venarum: receives blood from the superior and inferior vena cavae. It has smooth walls and is derived from the embryonic sinus venosus.
           • Atrium proper: It is derived from the primitive atrium, and has rough, muscular walls formed by pectinate muscles.
       • Left
         • Inflow portion: receives blood from the pulmonary veins. Its internal surface is smooth and it is derived from the pulmonary veins themselves.
         • Outflow portion: includes the left auricle. It is lined by pectinate muscles, and is derived from the embryonic atrium.
     • Ventricle
       • right and left
         • Inflow Portion has irregular muscular called trabeculae carnae
           • Outflow portion: smooth walls and no trabeculae carneae
   • Conduction of the heart
     • The main components of the cardiac conduction system are the SA node, AV node, bundle of His, bundle branches, and Purkinje fibers.
   • Cardiac action potential
     • Sinoatrial (SA) node: 60-100 BPM. Atrioventricular (AV) node: 40-60 BPM. Purkinje fibers: 20-40 BPM
       • Automaticity: spontaneous depolarization and an action potential is triggered when threshold voltage is reached.
   • Syncope
   • ECG
     • Electrocardiography (ECGorEKG]) is the process of recording the electrical activity of the heart over a period of time
       • Each small square represents 0.04 seconds. Each large square on the paper represents 0.2 seconds. 5 large squares therefore = 1 second. 300 large squares = 1 minute
   • Arrhythmias
     • Ventricular Arrhythmias
       • Ventricular Tachycardia feel as "skipping beats”•Ventricular Fibrillation (most serious arrhythmia) •Premature Ventricular Contractions- less serious type
     • Supra-ventricular arrhythmias
       • Supraventricular Tachycardia (SVT) Paroxysmal Supraventricular Tachycardia (PSVT) •Atrial Fibrillation •Wolff-Parkinson-White Syndrome •Atrial Flutter •Premature Supraventricular Contractions
   • Sick Sinus Syndrome
     • Symptoms
       • Slower than normal pulse (bradycardia). Fainting (syncope) Feeling tired all the time (fatigue). Weakness Shortness of breath (dyspnea). Chest pain (angina). Disturbed sleep. Confusion. Heart palpitations
     • Risk Factors
       • Age- Previous heart attack (myocardial infarction) -Medications to treat High Blood Pressure and other heart diseases Hyperkalemia (too much potassium in the blood) -Thyroid disease -Sleep apnea -Heart surgery
     • may be associated with conditions such as:
       • Diphtheria - Hemochromatosis (excess iron in the blood) -Muscular dystrophy - Amyloidosis (a condition in which a protein called amyloid is deposited in tissues or organs)
     • complications
       • 1. stroke . 2, peripheral thromboembolism
     • Treatment
       • implantation of a pacemaker
         • oral theophylline if bradycardia is the major manifestation (sympathomimetic)
   • CPR
     • is a lifesaving technique useful in many emergencies, including heart attack •CPR can keep oxygenated blood flowing to the brain and other vital organs until emergency surfaces arrive. •CPR should be performed immediately on any person who has become unconscious and is found to be pulseless.

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