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Cardiac Perfusion

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... afterload, contractility Peripheral vascular resistance Blood volume Blood viscosity Artery ... Perfusion & Coronary Artery Disease Last modified by: – PowerPoint PPT presentation

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Title: Cardiac Perfusion


1
Cardiac Perfusion
  • Lewis, ch 32

2
About Perfusion
  • The essential function of the CV and pulmonary
    systems is to provide a continuous supply of
    oxygenated blood to every cell in the body (see
    next slide).
  • Changes in perfusion affect all human functions
    such as self-care, mobility, FV, respiration,
    tissue integrity, elimination, and comfort.

3
Normal Blood Flow
4
Perfusion and the Heart
  • The heart muscle receives its blood supply from
    the coronary arteries during diastole (resting
    phasebetween beats)
  • The quality of heart perfusion depends on the
    condition of the coronary arteries.
  • The quality of perfusion to the body depends on
    the condition of the heart.
  • Therefore, if the heart does not have good
    perfusion, the body wont either.

5
Heart Perfusion
6
Factors Affecting Perfusion
  • Cardiac output (SV x HR)
  • Preload, afterload, contractility
  • Peripheral vascular resistance
  • Blood volume
  • Blood viscosity
  • Artery elasticity
  • Oxygen saturation

7
Assessment of Perfusion History
  • MI, valve disease, pacer
  • Hypertension
  • Diagnostic tests, hospitalizations, surgery
  • Rheumatic fever, strep
  • Cardiac meds
  • Risk factorsmodifiable, nonmodifiable

8
History contd
  • S/Spain, wt gain, swelling, palpitations,
    cough, dizziness, tingling
  • Problems with ADLsDOE
  • Sleep problemsPND, pillows
  • Sexual concerns
  • Cultural influences
  • Problems with self image or relationships

9
Chest Pain Assessment
  • P Precipitating events
  • Q Quality
  • R Radiation
  • S Severity
  • T Timing

10
Assessment of Perfusion Physical Assessment
  • Blood pressure
  • Pulse rate, quality, and rhythm
  • Heart sounds
  • Lung sounds
  • Neck veins
  • Breathing pattern

11
Heart Sounds
12
Pulse Sites
13
Assessment contd
  • Skin color and temperature
  • Ulcerations, edema
  • Color of mucous membranes, nail beds
  • Hair distribution on LEs
  • Nail texture shape
  • Level of consciousness
  • Urine output

14
Diagnostic Assessment of Cardiac Function
  • Doppler ultrasound
  • Electrocardiogram
  • Echocardiograms (757)
  • Stress test/Nuclear scan
  • CXR (756), CT (759), MRI
  • Cardiac catheterization (left) (759)
  • Labstroponin, CK-MB, lipids

15
Conduction System
16
Relationship of ECG Heart Sounds
17
Manifestations of Poor Perfusion
  • Confusion
  • Low blood pressure
  • Rapid or irregular heart rate
  • Shortness of breath
  • Decreased or absent pulses
  • Chest or extremity pain
  • Low urine output
  • Edema
  • Cold skin
  • Pale, gray, or blue skin color
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