Essay on Ch 19 CaseStudy3 VSD SSL

b. Where do you think would be the best place to auscultate Caleb’s abnormal heart sound? Explain your answer. The abnormal heart

In a normal human being the heart correctly functions by the blood first entering through the right atrium from the superior and inferior vena cava. This blood flow continues through the right atrioventricular valve into the right ventricle. The right ventricle contracts forcing the pulmonary valve to open leading blood flow through the pulmonary valve and into the pulmonary trunk. Blood is then distributed from the right and left pulmonary arteries to the lungs, where carbon dioxide is unloaded and oxygen is loaded into the blood. The blood is returned from the lungs to the left

The blood that does not cross the foramen ovale into the left atrium is emptied into the right ventricle which is then pumped into the pulmonary artery to be carried to the lungs. The third fetal shunt is encountered; the ductus arteriosus allows blood to be shunted from the pulmonary artery to the aorta and systemic arteries following. Blood that does go to the lungs are returned by the pulmonary veins to the left atrium and emptied into the left ventricle. (Perinatal and Pediatric Respiratory Care, Ch2 p 17-18) Shortly after birth due to changes in vascular resistance blood is redirected to the lungs for oxygenation and these shunts are no longer required leading to their closure within a few days postpartum. In HLHS, because the left heart structures are insufficient to receive and pump adequate amounts of oxygenated blood to supply the tissues the patency of the foramen ovale and the ductus arteriosus are essential to sustaining life. (PubMed – ADAM Medical Encyclopedia, 2013) Medical intervention is needed to maintain the patency of the ductus arteriosus and an atrial septal defect is created in place of the foramen ovale.

It is considered to account for the most deaths during the first week of an infant’s life who suffers from a congenital heart defect (Texas Heart Institute, 2014). In a healthy heart, oxygen-poor blood returns to the heart from the body. The heart receives the blood through the veins and enters the right atrium where it then pushes the blood through the tricuspid valve into the right ventricle. From here, the blood moves through the pulmonary valve out of the heart via the pulmonary artery and into the lungs where it receives oxygen to be transported. The blood returns to the heart by the pulmonary veins into the left atrium where it is then passed through the mitral valve into the left ventricle. Oxygen-rich blood is pumped from the left ventricle into the aorta through the aorta valve where it is then sent throughout the body, returning to the right atrium to continue the cycle (American Heart Association,

7.ECG: To see the evidence of ischemic changes, cardiomegaly suggestive of heart failure or evidence of left ventricular hypertrophy.

The heart’s moves oxygen-rich blood from the lungs to the left atrium onto the left ventricle which then pumps it to the rest of the body. The left ventricle generates the heart’s pumping power therefore it is larger than the other chambers. In left-sided heart failure, the left side of the heart works harder to pump the same amount of blood that is normally pumped. There are two types of left-sided heart failure- the systolic and the diastolic. In systolic failure, the left ventricle is not able to normally contract and the heart cannot push enough blood into the circulation. In systolic failure, the left ventricle is not able to relax because the muscle has become stiff. As a result, the heart cannot properly fill with blood during resting period between each beat. Right-sided heart failure is another type of heart failure that results from the failure of the left-side. The heart’s pumping action moves blood that returns to the heart though the veins through the right atrium and then onto the right ventricle which pumps the blood back out of the heart into the lungs to be replenished with oxygen. When the left ventricle

From an early age Cecil Palmer was active – tennis, karate and dance were just a few of his childhood hobbies. Dance ultimately became much more than a hobby and lead to a career as a professional dancer, actor and choreographer and the opportunity to work with variety show and comedy stars like Sonny and Cher and Lucille Ball. Years ago, Cecil learned that he had an innocent heart murmur, but it wasn’t a cause for concern or treatment. In fact, according to the American Academy of Family Physicians, roughly 80 percent of all children have a heart murmur at some time. Innocent heart murmurs are typically found in children, but can carry on through adulthood.

Oxygenated and deoxygenated blood have different colorations, but deoxygenated blood is not blue like many people think. The blood is actually a deep crimson color, and the idea that it's blue probably originated from the appearance of blue veins, which are so colored because of your skin, not your blood.

The normal flow of blood through the heart consists of the entry of blood to the right atrium through to the right ventricle and then the blood passes through the tricuspid valve entering the lungs and then through to the left atrium and to the left ventricle via the mitral valve and finally into the body. During fetal development, however there are the risks for congenital anomalies. These congenital heart disorders consist of Atrial septal defect (ASD) and Ventricular septal defect (VSD). ASD is one of the common congenital heart defects that requires interventional measures or repair. The condition occurs when the foramen ovale the opening between the atria prior to birth does not close and there

After birth, a physical examination is conducted on the infant and with the help of a stethoscope, cardiac murmurs (i.e. extra or unusual sounds) can be heard, which indicate an underlying pathology. In order to determine the nature of the pathology, imaging studies such as a chest X-ray, cardiac MRI and echocardiograms may be done. Electrocardiograms are also of diagnostic value.

To discover heart murmurs it is important to initiate an assessment of the cardiovascular system. Inspection of jugular veins for irregular pulsations should be noted. Observe for elevated (raised) pulsations in the jugular vein with patients head turned at an angle with a penlight and estimate jugular venous pressure. Palpate the carotid arteries by gently pressing for strength of pulse. Findings for palpation should be documented as absent, palpable, normal, or bounding. Auscultation should be performed on each carotid artery using the diaphragm and bell of

Arrhythmias: auscultate apical pulse to detect an irregular heart rate or bradycardia; both indicate a reduced cardiac output, which requires immediate intervention.

Normally, blood from the right side of the heart is pumped to the lungs where the blood is oxygenated. The oxygenated blood from the lungs is then pumped to the left side of the heart. From the left side of the heart, blood is pumped out to the rest of the body. When an ASD occurs, blood from the left atrium mixes with blood in the right atrium. The blood is then recirculated to the lungs

Follow a systematic palpate the sternoclavicular, aortic, pulmonic, tricuspid and epigastric areas using a systematic sequence. Using the ball of hand find the apical pulse then tips of finger over the precordium. Note abnormal finding such as heaves, thrills and fine vibration (purring cat). Palpate the other arterial pulses by pressing with the pads of your index and middle finger. Start at the temporal artery and work down to the dorsalis pedis pulse. Abnormal finding such week pulse could be due to cold weather or can indicate sever heart failure or peripheral vascular disease. Strong or bounding pulsations usually occur in a patient with a condition that causes increased cardiac output, such as hypertension, hypoxia, anemia, exercise, or anxiety. A thrill usually suggests a valvular dysfunction.

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