CARDIOVASCULAR TEST ESSAY QUESTION (25 points) A middle- aged woman is admitted to the coronary care unit with a diagnosis of left ventricular failure resulting from a myocardial infarction. Her chart indicates that she was awakened in the middle of the night with severe chest pain. Her skin is pale and cold. Moist sounds of pulmonary edema are beard over the lower regions of both lungs.(5 points each-Please labeleach answer with the section number and separate the paragraphs so 1 may grade easily and award proper credit to your answers) 1. Draw and label a human adult heart.2 List all arteries and veins that play a major role in this coronary myocardial infarction and pulmonary edema.3. Draw and label what her ECG would look like.4 What blood related conditions might result in her skin being pale and cold? Explain how failure of the left ventricle might cause these signs and symptoms the circle numo ers.

Explanation:

Ans:2: the coronary blood supply involved in myocardial infarction(Left ventricular failure ) and pulmonary eodema are:-

1. The anterior descending branch of Left Coronary Artery, which supplies most of the apex of the heart, anterior surface of left ventricle, adjacent third of ant. wall of right ventricle and the ant 2/3rd of interventricular septum.

2.The circumflex branch of Left Coronary artery, which supplies left atrium and a small portion of lateral aspect of left ventricle.

3. The Right Coronary artery which supplies the right atrium,remainder surface of anterior surface of right ventricle, the adjacent half of posterior wall of left ventricle and posterior third of interventricular septum.

4. Pulmonar vein which carries oxygenated blood from the lungs.

5. Pulmonary artery which carries de oxygenated blood from the heart.

Answer 4:

The blood in the heart chambers move in the following direction:

venous blood from systemic circulation--->Rigt atrium--->Right ventricle--->pulmonary arteries--->lungs--->pulmonary veins--->left atrium--->left ventricle:>Aorta---> systemic arterial supply.

As per the above explanation,when there is left ventricular failure there will be less amount of blood pumped into the aorta, which in turn will supply less blood into the systemic arterial supply. Less amount of blood will lead to less amount of oxygen in the tissues which will cause anoxia. Anoxia will cause cyanosis and coldness of extremities.

Answer 5::

The mechanism of clinical manifestation resulting from heart failure can be explained by the following concept:

a) Forward Heart Failure which is due to failure of the heart to pump blood causing diminished blood flow to the tissues .

It causes anoxia, angina, cyanosis and coldness of extremities.

Tissue anoxia causes decreases renal perfusion-->activation of renin-angiotensin-aldosterone system-->Na+ and H2O retention-->pulmonary congestion and oedema.

b)Backward failure which is due to increased residual volume in the ventricles when it fails to eject blood normally..

This causes increase in left atrial pressure and volume-->increase pressure in pulmonary venous circulation-->increase in pulmonary arterial pressure-->systemic venous congestiona and peripheral oedema.

Systemic venous congestion leads to oedema on dependent parts of the body,passive congestion of liver, spleen, kidney,ascites, hydrothorax,congestion of neck veins and lleg veins.

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