UNIT 1: THE CARDIOVASCULAR SYSTEM (pt.2)

P wave, PR interval, QRS complex, T wave

Electrocardiogram (ECG) Cycle:

P Wave

Electrical impulse spreading through atria

P Wave

represents atrial depolarization.

PR Interval

Time required for impulse to travel from SA node through AV node to ventricles (0.12–0.20s)

0.12–0.20s

PR Interval time required:

QRS Complex

 Impulse spreading through ventricles

QRS Complex

represents ventricular depolarization

<0.12s

QRS Complex time:

T Wave

Ventricular muscle recovery phase

T Wave

represents ventricular repolarization

Risk Factors

Attributes or exposures that increase the probability of developing cardiovascular disease

Non-Modifiable Risk Factors and Modifiable Risk Factors

Risk Factors Classification:

Non-Modifiable Risk Factors

Inherent genetics or demographics that cannot be changed

Modifiable Risk Factors

Lifestyle behaviors or metabolic conditions that can be prevented, managed, or treated

Age, Gender, Race/Ethnicity, Family History

Non-Modifiable Risk Factors:

vascular changes, myocardial stiffening

Risk increases significantly with advancing age due to ___

decreased estrogen

Women's risk increases sharply post-menopause due to ___

< 55 ; < 65

Family History: First-degree relative with early-onset CAD (Men ___ yrs, Women ___ yrs)

Hypertension, Dyslipidemia, Diabetes Mellitus, Abdominal Obesity, Cigarette Smoking / Tobacco Use, Physical Inactivity, Diet High in Saturated Fats & Sodium, Psychosocial Factors

Modifiable Risk Factors:

≥ 140/90 mmHg

Hypertension BP is

Hypertension

 Increases myocardial workload

atherosclerosis

Hypertension accelerates ___

• Elevated Low-Density Lipoprotein (LDL)

• Elevated Triglycerides

• Low High-Density Lipoprotein (HDL)

Dyslipidemia includes:

Diabetes Mellitus

Accelerates microvascular and macrovascular damage

Diabetes Mellitus

 alters lipid metabolism

Abdominal Obesity

Linked to metabolic syndrome and systemic inflammation.

Nicotine

it causes vasoconstriction and surges catecholamines

catecholamines

Nicotine causes vasoconstriction and surges __

Carbon monoxide

___ decreases oxygen-carrying capacity

Physical Inactivity

Sedentary lifestyle impairs lipid metabolism and endothelial function.

lipid metabolism and endothelial function

Sedentary lifestyle impairs ____.

Diet High in Saturated Fats & Sodium

Contributes to dyslipidemia and fluid retention

Chronic stress, anxiety, depression, and Type A personality patterns.

Psychosocial Factors:

• Quiet, warm room with proper lighting.

• Client in supine position with head elevated 30 degrees to 45 degrees

Assessment Environment:

• Stethoscope with both Bell (low-pitched sounds) and Diaphragm (high pitched sounds).

• Centimeter ruler for Jugular Venous Pressure (JVP) measurement.

• Sphygmomanometer & Penlight.

Essential Equipment:

bell

low-pitched sounds part of the stethoscope

Diaphragm

high-pitched sounds part of the stethoscope

Level of consciousness, facial expression, body posture, respiratory effort

General Impression:

Blood Pressure, Heart Rate & Rhythm, Respirations

Vital Signs Evaluation

30 - 40 mmHg

normal pulse pressure:

Postural hypotension

refers to a drop in blood pressure associated with changing position, particularly when moving from lying or sitting to standing.

Tachycardia, bradycardia, or irregular rhythms

Heart Rate & Rhythm:

Tachypnea, orthopnea, or Cheyne-Stokes pattern in severe heart failure

Respirations:

Orthopnea

difficulty breathing when lying flat.

Cheyne-Stokes pattern

This is a breathing pattern characterized by changes in the depth and pattern of breathing, including periods of increasingly deeper breathing followed by decreasing breathing and periods of apnea.

Central Cyanosis

Bluish discoloration of tongue/mucous membranes

Central Cyanosis

inadequate arterial oxygenation

Peripheral Cyanosis

Discoloration of extremities/fingers

Peripheral Cyanosis

sluggish peripheral circulation

Pallor

Reduced arterial perfusion or anemia

 < 2 seconds

normal Capillary Refill:

poor peripheral perfusion

delayed refill indicates ___

Clubbing

loss of vascular angle

chronic hypoxemia

Clubbing indicates __

Precordial Inspection

Observe the anterior chest wall for abnormal pulsations, lifts, or heaves.

5th intercostal space (ICS), left midclavicular line

Locate the Apical Impulse (Point of Maximal Impulse - PMI) at the ____.

Jugular Venous Distension (JVD)

Assesses right atrial pressure (RAP).

 ≤ 3-4 cm above the sternal angle at a 30 degrees to 45 degrees angle

Normal jugular venous pressure:

right-sided heart failure or fluid overload

Distension indicates ___