National Nursing Review : Nursing Study Resources & Health Tips

Inability of the heart to assume its function of pump and propulsion of blood to meet the metabolic needs of the organization. Heart failure is the result of most cardiac pathologies, it is common and serious, because its mortality is estimated at 50% at 5 years.

Etiologies:
Heart failure (or ventricular) may be secondary to left:

• Hypertension by chronic increase of afterload with left ventricular hypertrophy
• A valvular (narrowing or aortic insufficiency or mitral)
• Ischemic heart disease (reduction or stoppage of blood flow in one or more arteries of the heart),
• Hypertensive cardiomyopathy, toxic, or deficiency (beri beri)
• Obstructive cardiomyopathy
• Myocarditis (myocarditis, inflammatory rheumatic or Chagas disease, common in South America)
• Arrhythmias,
• Profound anemia
• Hyperthyroidism
• Ischemic by coronary atherosclerosis

Heart failure (or ventricular) is right most often follows:

• Left heart failure + + +
• Pulmonary hypertension, itself caused by a lung disease (chronic bronchitis, emphysema, pulmonary embolism)
• CHD
• Mitral stenosis
• Chronic lung disease

Chronic heart failure:
Often a consequence of hypertension in the small or large circulation, during which the heart muscle to pump against the increased pressure in the vessels. The ventricle must provide more work. (more…)

Necrosis confined to a more or less tissue myocardial ischemia resulting from a sudden coronary artery. During a myocardial infarction, irrigation is no longer; deprived of blood and oxygen, the myocardial cells suffer and die, releasing their cardiac enzymes, with destruction of surrounding tissue. Men are affected twice as often as women. Myocardial infarction is one of the most common causes of death.
Today, the very definition of myocardial infarction tends to disappear in favor of acute coronary syndrome ST more versus acute coronary syndrome not included ST.

Causes:
The occlusion of one or more coronary arteries is almost always due to the formation of a thrombus (clot) on a plaque consisting of cholesterol deposits against the inner arterial wall. This condition occurs most often in patients with risk factors such as smoking, hypertension, high cholesterol, diabetes, sedentary lifestyle.

Symptoms
In half the cases, infarction occurs after a period shorter or longer during which the subject suffers from angina.
The pain (tightness, burning, sometimes crushing) are felt behind the breastbone (retrosternal), and can radiate to the left arm to the jaw, sometimes in the back. They disappear in a few minutes rest, sometimes with the use of a spray nitro.
In the other half of the cases, stroke is opening, that is to say that there are no warning signs. It manifests itself by severe pain sharp retro sternal (such as angina but longer and more intense). The pain may radiate to the arm, jaw and back. It is often constrictive and accompanied by anxiety and feeling of impending death. (more…)

It is defined as a state of hypo-perfusion tissue associated with dysfunction of the heart pump. Its main cause is myocardial infarction in acute phase.
Cardiogenic shock from myocardial infarction is associated:

• the extent of necrosis of the left ventricular mass mainly
• a mechanical complications: cardiogenic shock secondary
• septal rupture responsible for CIV
• acute mitral regurgitation due to rupture or dysfunction pillar of mitral
• much more rarely, rupture of the free wall of left ventricle in charge of tamponade.
• the extension of an infarction less than the right ventricle

Symptoms:
In addition to signs of acute infarction, there are signs of tissue hypoperfusion:

• neurological signs: agitation, confusion, stupor,
• Signs peripheral coldness, pallor, mottling, cyanosis,
• Renal signs: oligo-anuria,
• hemodynamic signs: systolic blood pressure <90 mm Hg, toe pressure differential pressure, tachycardia with pulse spinning,
• signs of elevated filling pressures left (pulmonary edema, gallop …) and right (jugular turgor, hepato-jugular reflux).

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The heart muscle does not require external stimulation to contract, but the autonomic nervous system exerts a considerable influence on the latter.
The control centers of the cardiac autonomic nervous system located in the medulla oblongata: the cardio accelerator center plans neuronal extensions even neurons segments T1 -> T5 spinal cord, which synapse with postganglionic neurons of cervical lymph and upper chest, from where they are nerve fibers synapse with sinus and atrioventricular nodes.
The cardiovascular center inhibitor, it has the nerve fibers which leave the medulla oblongata to the heart via the nerve X.

The phenomena of electrical stimulation:
The cells are pacemakers in the sinus node, the atrioventricular node and atrioventricular bundle (bundle of His). The sinus node is located in the wall of the right atrium. It is the primary pacemaker center: typically, the sinus node depolarizes spontaneously 70 times per minute, and mark the pace of all contractile cells. (more…)

Definition

All chest pain event related to a “narrowing of the size” of one or more coronary arteries. The coronary arteries are the arteries that supply blood to the heart muscle.

Clinical Data

Clinical examination was unremarkable.
The resting ECG was completely normal except for a painful crisis.
Any interrogation can find angina:
with chest pain to left arm
to pain on exertion and rest
pain in 3 to 4 minutes,
took to heart in a vise.

Pathophysiology

Suffering infarction: ischemia is associated with a mismatch between needs and the oxygen supply of heart muscle:
is the input can not increase in proportion to needs: angina of effort
is in constant need, contributions are reduced: spastic angina.
The decrease in arterial size is secondary to a “collection” by atherosclerotic plaques. (more…)

Anatomically, the heart was nearly the size of a fist for a weight ranging from 250 to 350g. It lies within the mediastinum, extending from the 2nd to 5th coast intercostal space between the spine and sternum, surrounded by the lungs, its apex resting on the diaphragm.

I-The pericardium:

The outer core is called the pericardium, made of dense and strong, protecting the heart, then two layers, one parietal and other visceral, defining a virtual cavity, where the cells produce pericardial fluid in serous for lubrication.

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