Cardiac Physiology

2381 WordsJun 25, 201310 Pages
Module 5 CARDIAC PHYSIOLOGY Case No. 1 Melvin Rodriguez was admitted at the intensive care unit. On the first hospital day, he developed hypotension, BP of 70/40, cardiac rate of 100 beats per minute, rales all over lung fields, respiratory rate of 24 breaths per minute. Pertinent physical examination showed patient was dyspneic, distented neck vein. Patient was on left ventricular failure with pulmonary congestion. Questions 1. What is the Frank starling law of the heart? The Frank–Starling law of the heart (also known as Starling's law or the Frank–Starling mechanism or Maestrini heart's law) states that the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end…show more content…
Digoxin enhances myocardial inotropism and automaticity but slows impulse propagation through the conduction tissues. Digitalis reciprocally facilitates calcium entry into the myocardial cell by blocking the Na K adenosine triphosphatase pump. This calcium influx may account for its positive inotropic action because this inotropic response is not catecholamine- or beta receptor- dependent and is therefore effective in patients taking beta-blocking drugs. Digitalis was expected to increase contractility and return the Frank-Starling relationship toward that seen in a normal ventricle. 5. Why was he sent home on a low sodium diet? Sodium is usually limited to prevent fluid accumulation. A low sodium diet was recommended to reduce extracellular fluid volume and blood volume, and to prevent subsequent episodes of pulmonary edema. Case No. 3 Theresa Camantiles was a 38 year old home maker and mother of 4 children. Keeping house and driving the children to activities kept her busy. To stay in the shape, she took aerobics classes at the local community center. The first sign that Theresa was ill was vague; she fatigued easily. However, within 6 months, Theresa was short of breath, both at rest and when she exercised, and she had swelling in her legs and feet. She then sought medical consult. On physical examination, she had distended jugular vein, liver was enlarged and had ascites in her peritoneal cavity and edema in her legs. A fourth
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