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Chapter 22 Cardiac Failure. Acute Pulmonary Edema. Buildup of Blood in Lungs. Increased Venous Return. Insufficient Pumping. Increased Capillary Pressure. Buildup of Fluid in Lungs. Peripheral Vasodilation. Diminished O 2 Transport. Treatment for Pulmonary Edema.
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Acute Pulmonary Edema Buildup of Blood in Lungs Increased Venous Return Insufficient Pumping Increased Capillary Pressure Buildup of Fluid in Lungs Peripheral Vasodilation Diminished O2 Transport
Treatment for Pulmonary Edema • Tourniquets on arms and legs • Bleeding the Patient • Diuretic (e.g. furosemide) • Pure O2 to breathe • Cardiotonic drug (e.g. ouabain) to strengthen the heart
Cardiac Reserve • Maximum amount that the CO can increase. • Generally 300-400%. • Can be 500-600% in athletes. • Can be zero for diseased heart.
Exercise Test • Put on a treadmill • Look for • Shortness of breath • Muscle fatigue • Increased heart rate.
Graphical Analysis of Cardiac Output AV Fistula Normal Normal Venous Return
Heart Defects • Patent Ductus Arteriosis (PDA) • Tetralogy of Fallot • (Left to Right Shunt) • Blue Baby • 4 abnormalities • Aorta (partially) originates from RV • Stenosed Pulmonary artery • Blood from the RV passes through a septal hole • Right Ventricular Hypertrophy • German Measels is a common cause of heart defects.
Extracorporeal Circulation • Methods: • Bubbling O2 through blood • Dripping blood over a large surface • Passing blood over rotating discs • Passing blood through thin membranes or porous tubes • Problems: Hemolysis, Clotting, Bubbles, Emboli of antifoam agent, need for large quantities of blood, need for heparin (inteference with hemostasis).
Cardiac Hypertrophy Caused by Congenital and Valve Diseases • Generally occurs with all defects • Part of heart affected depends on type of defect • Extreme hypertrophy can cause heart failure • Coronary vasculature does not increase • Fibrosis often develops (especially subendocardial) • Ischemia can cause anginal pain.