G.+Cardiology


 * C*A*R*D*I*O*L*O*G*Y **

The prefix "cardio-" means heart. The word comes from the Greek, "kardia," which also means heart. The heart typically weighs on average of 11 ounces. Doctors that specialize in cardiology and become a cardiologist not only complete extensive training through medical school, but typically up to three years of a residency, completion of their license exam and usually three years of training as a cardiologist. The heart is truly the hardest working "muscle" in our body and a complex organ.

__**I. Cardiac Output **__  *The cardiac output is the volume of blood pumped by either the right or left ventricle each minute *The average output is 5,500 ml (5.5 L) per minute. *The total blood volume also is about 5.5 L *Stroke volume (SV) is the volume of blood pumped per beat by each ventricle *Cardiac Rate (CR) is your beats per minute

 You can calculate the output by using this equation: Cardiac Output (ml/mn) = Stoke volume (ml/beat) x Cardiac Rate (beats/min)

__**II. Measurements of Blood Pressure **__  *Stephan Hales (1677-1761) was noted as the first documentated person having measured blood pressure. *Systolic pressure is the maximum arterial pressure during contraction of the left ventricle of the heart *Distolic pressure is the minimal arterial pressure during relaxation and when the ventricles of the heart dilate and fill with blood *A pressure cuff and sphygmomanometer are used to measure blood pressure *Pulse pressure is the difference between systolic and diastolic *A pulse is produced by the rise in the pressure from the diastolic and systolic pressure levels

You can calculate your pulse pressure by using this equation: Pulse pressure = Systolic pressure - Diastolic pressure

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__**III. Classifications of Shock **__ *There are early and late signs of shock *Some early signs are decreased Na+ concentration in urine, decreased pulse pressure and increased pH (alkalosis) due to hyperventilation *Some late signs are decreased systolic pressure, decreased volume in urine and decreased pH (acidosis) due to metabolic acids *Circulatory shock occurs when there is inadequate blood flow or oxygen use by the tissues *Hypovolemic shock refers to circulatory shock in terms of the low blood volume *Septic shock is caused from hypotension, low blood pressure typically from an infection or sepsis *Anaphylactic shock happens with a fast fall in blood pressure typically caused as a severe result of an allergic reaction *Neurogenic shock also classifies under as having a quick fall in blood pressure and is usually due to upper spinal cord damage or spinal anesthesia *Cardiogenic shock is caused from cardiac failure

__**APPLICATION:**__ In working in a hospital setting as a pharmacist, heart problems and diseases are a main reason for many patients. It can affect patients who are newborns to patients who are elderly. There is a wide variety of drugs that treat low and high blood pressure. Intensive care has specialized trained pharmacist that helps maintain comfort care and help monitor cardiac conditions. Medical professionals try to help teach and promote healthy lifestyle living through examples of changing poor diet or exercise habits and medication therapy is an aid to helping your body function and maintain itself. Familiar drugs like epinephrine and norepinephrine work together to help give the body energy through increasing cardiac output. Some familiar examples of blood pressure medication are Lopressor, Amlodopine, Metoprolol, Propanolol and Diltiazem. Below is a flow chart on initial drug choices regarding the different stages of hypertension.



__**Essential Questions **__ The three most important variables that affect blood pressure are cardiac rate, stroke volume and total peripheral resistance. Cardiac rate is the beats per minute of the heart and stroke volume is the volume of blood pumped per beat by each ventricle. The total peripheral resistance is the overall resistance to blood flow through the systemic blood vessels. If all three increase and there is no decrease to offer equilibrium between them all, then there will be an increase in blood pressure. Two reflexes that help maintain blood pressure are the barorecepter reflex and atrial stretch reflexes. Barorecpter reflex are the stretch receptors located in the aortic arch and in the carotid sinuses. They are constantly active and produce a frequency of action potentials in their sensory neurons. The atrial stretch reflexes is located in the atria of the heart. These specific receptors are activated by increased venous return to the heart.

http://thumbs.dreamstime.com/thumblarge_105/1166117619zrCF28.jpg http://www.youtube.com/watch?v=ElCbQMiBC6A&feature=related <span style="color: #ff0000; font-family: Georgia,serif;"> http://flightphysical.com/Exam-Guide/BP/NIH/images/NIH-BP-Guidelines_img_11.jpg <span style="color: #ff0000; font-family: Georgia,serif;">Fox, Stuart Ira. Human Physiology, 11th ed. New York: 2009.
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