Cardiac Exam Outline
I. Physiology review
a. Heart Chambers
i. Right Chamber
ii. Left Chamber
iii. Atria
iv. Ventricles
b. Coronary Arteries
i. If either gets blocked, heart muscle on that side die
c. Systole vs Asystole
d. Electrical Conduction – SA node
i. An area of the heart that transmits impulses triggering the heartbeat from
one end of the heart to the other
e. Cardiac Output: 4L/min is normal
i. Preload
1. Amount of blood in the ventricles at the end of diastole
2. How well the pump is primed
3. The amount of stretch in the muscle tissue at the end of filling
ii. Afterload
1. Resistance to flow the ventricle must pump against to open the
valve and eject blood out into the body
2. Hypertension increases afterload (arterial vasoconstriction)
3. Calcified (stenosed) valves increase afterload
4. Increased afterload puts extra stress on the heart
iii. Contractility
1. Mechanical force of contraction
2. Affected by the quality of muscle tissue
3. Affected by presence of O2 and correct pH
iv. Syncope: drop in cardiac output resulting in passing out
v. Cardiac Output Calculation: Stroke Volume x Heart Rate
II. Gerontology Considerations
a. Risk factors
i. Increased connective tissue
ii. Stiffer, less muscle
iii. Blood vessels are less elastic
iv. Baroreceptors not as good
v. Endocardium – fibrosis
vi. Myocardium not as responsive
vii. Valves develop calcification (stenosis)
b. Watch for…
i. Arrhythmias
ii. Avoid Anxiety
iii. Excess Exertion
iv. Prolonged Activity
c. Cardiac Symptoms
