Introduction to the Cardiovascular System

The cardiovascular system consists of the heart and a complex network of arteries and veins. The heart serves as a pump to transport blood throughout the body. The healthy functioning of the cardiovascular system is foundational to the health of all other body systems because the transportation of blood directly impacts the cellular functioning of all tissues and organs.

This chapter will review common word components related to the cardiovascular system to assist learners in analyzing, building, and defining medical terms. Other terms, whose definitions cannot be easily built from word components, will be described in context based on the anatomy and physiology of the cardiovascular system and common diseases and disorders. Medical specialists, diagnostic tests, and procedures related to the cardiovascular system will also be discussed.

References

1.

CrashCourse. (2015, July 6). The heart, Part 1 - Under pressure: Crash Course Anatomy & Physiology #25 [Video]. YouTube. All rights reserved. https://youtu​.be/X9ZZ6tcxArI?si​=lDbroqj9mvfnGdar ↵.

Common Prefixes Related to the Cardiovascular System

• a-: Absence of, without
• bi-: Two
• brady-: Slow
• dys-: Bad, abnormal, painful, difficult
• endo-: Within, in
• epi-: On, upon, over
• hyper-: Above, excessive
• hypo-: Below, deficient
• inter-: Between
• pan-: All, total
• peri-: Surrounding, around
• poly-: Excessive, over, many
• tachy-: Fast, rapid
• tri-: Three

Common Word Roots With a Combining Vowel Related to the Cardiovascular System

• angi/o: Vessel
• aort/o: Aorta
• arteri/o: Artery
• ather/o: Yellowish, fatty plaque
• atri/o: Atrium
• card/i or cardi/o: Heart
• coron/o: Heart, crown, or circle
• ech/o: Sound
• electr/o: Electricity
• isch/o: Deficiency, blockage
• my/o or myos/o: Muscle
• plasm/o: Plasma
• symptomat/o: Symptom
• thromb/o: Clot
• valv/o or valvul/o: Valve
• vas/o: Vessel
• ven/o: Vein
• ventricul/o: Ventricle

Common Suffixes Related to the Cardiovascular System

• -ac: Pertaining to
• -ade: Process of
• -al: Pertaining to
• -apheresis: Removal
• -ar: Pertaining to
• -centesis: Surgical puncture to aspirate fluid
• -dynia: Pain
• -ectomy: Excision, surgical removal
• -emia: Condition of blood
• -genic: Producing, originating, causing
• -gram: Record, radiographic image
• -graph: Instrument used to record
• -graphy: Process of recording, radiographic imaging
• -ia: Condition of, diseased state, abnormal state
• -ic: Pertaining to
• -ion: Process
• -itis: Inflammation
• -lgia: Pain
• -logist: Specialist who studies and treats
• -lysis: Loosening, dissolution, separating
• -megaly: Enlarged, enlargement
• -oma: Tumor
• -osis: Abnormal condition
• -ous: Pertaining to
• -pathy: Disease
• -penia: Abnormal reduction in number
• -pexy: Surgical fixation, suspension
• -plasty: Surgical repair
• -poiesis: Formation
• -sclerosis: Hardening
• -scope: Instrument used to view
• -scopy: Process of viewing
• -stasis: Stop, stopping, controlling
• -stenosis: Narrowing, constriction
• -tomy: Cut into, incision

The Heart

The heart is located within the thoracic cavity, medially between the lungs, and in the space known as the mediastinum. The great veins (the superior and inferior venae cavae) and the great arteries (the aorta and pulmonary artery) are attached to the superior surface of the heart called the base. See Figure 9.1[1] for an illustration of the heart in the thoracic cavity.[2] The inferior tip of the heart, the apex (Ā-peks), lies just to the left of the sternum between the junction of the fourth and fifth ribs. Health care professionals must know the position of the heart when placing a stethoscope (STETH-ŏ-skōp) to listen to heart and lung sounds, referred to as auscultation (os-kŭl-TĀ-shŏn).[3]

Figure 9.1

Position of the Heart in the Thoracic Cavity

See Figure 9.2[4] for an illustration of the heart. The heart consists of four chambers: two atria and two ventricles. The right atrium receives deoxygenated blood from the body via the inferior and superior vena cava. The right ventricle pumps the deoxygenated blood to the lungs. The left atrium receives oxygenated blood from the lungs and propels it into the left ventricle. The left ventricle pumps blood to the rest of the body.[5]

Figure 9.2

Anatomy of the Heart

Blood Vessels

After blood is pumped out of the left ventricle through the aorta, it is carried throughout the body via systemic arteries. An artery (AR-tĕr-ē) is a blood vessel that carries blood away from the heart. Arteries branch into ever-smaller vessels called arterioles (ar-TĒR-ē-ōlz) and eventually into tiny vessels called capillaries. See Figure 9.3[6] for an illustration of the systemic arteries that carry oxygenated blood throughout the body to organs and tissues, as indicated by the red color.

Figure 9.3

Arteries

Oxygen and nutrients are exchanged with cells at the capillary (KAP-ĭ-lār-ē) level. A capillary is a microscopic channel that supplies blood to the tissue cells. Capillaries connect arterioles and venules (VEN-yoolz), small veins (VĀNZ). See Figure 9.4[7] for an illustration of capillaries supplying blood to tissue cells.[8]

Figure 9.4

Capillaries

Veins return blood to the heart. Two large veins, the inferior vena cava and superior vena cava (VĒ-nă KĀ-vă), connect to the heart. See Figure 9.5[9] for an illustration of the systemic veins that carry deoxygenated blood back to the heart, indicated in blue. Medications may be administered by health care professionals into veins, referred to intravenous (ĭn-tră-VĒ-nŭs) (IV) medications.[10]

Figure 9.5

Systemic Veins

Coronary Arteries and Veins

Coronary arteries are arteries that branch off the aorta and carry oxygenated blood to the heart muscle itself. Coronary veins bring deoxygenated blood back to the right atrium. Blood circulates through the coronary arteries and veins with each heartbeat. See Figure 9.6[12] for an illustration of the coronary arteries and veins.

Figure 9.6

Coronary Arteries in the Heart

When a person has a myocardial infarction (mī-ŏ-kar′dē-ăl in-FARK-shŏn) (MI), a blockage in a coronary artery causes a lack of oxygenated blood flow to the heart muscle. If a significant area of the heart’s muscle tissue dies from lack of oxygenation, the heart is no longer able to pump.

References

1.

“2001​_Heart_Position_in_ThoraxN.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

2.

“Position of the Heart in the Thorax” by OpenStax College is licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/19-1-heart-anatomy ↵.

3.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

4.

“Heart_diagram-en​.svg.png” by ZooFari is licensed under CC BY-SA 3.0 ↵.

5.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

6.

“2120​_Major_Systemic_Artery.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

7.

“Illu_capillary_en​.jpg” by unknown author is licensed in the Public Domain. ↵.

8.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

9.

“2131​_Major_Systematic_Veins.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

10.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

11.

CrashCourse. (2015, July 20). Blood Vessels, Part 1 - Form and function: Crash Course Anatomy & Physiology #27. [Video]. YouTube. All rights reserved. https://youtu​.be/v43ej5lCeBo ^↵.

12.

“Surface Anatomy of the Heart” by OpenStax College is licensed under CC BY 4.0 ↵.

Pulmonary and Systemic Circulation

There are two distinct but linked circuits in the human circulation called pulmonary and systemic circuits.

The pulmonary circuit transports oxygenated blood from the right ventricle to the lungs, where carbon dioxide is delivered for exhalation, oxygen is picked up, and this newly oxygenated blood returns to the left atrium of the heart.[1]

The systemic circuit transports oxygenated blood from the left ventricle of the heart, through the aorta, and into the systemic arteries throughout the body where it diffuses into the tissues at the capillaries. Deoxygenated blood travels back to the heart by entering small veins that merge and eventually drain into the superior and inferior vena cava and into the right atrium of the heart. See Figure 9.7[2] for an illustration of blood flow through the pulmonary and systemic circuits.[3]

Figure 9.7

Blood Flow Through the Heart and the Pulmonary and Systemic Circuits

Transportation

The systemic and pulmonary circuits transport blood and its components for physiological processes that occur throughout the body[4]:

• The right ventricle pumps deoxygenated blood through the pulmonary arteries away from the heart to the lungs. (Note this is the only place in the body where arteries carry deoxygenated blood.) Oxygen from air inhaled into the lungs diffuses into the pulmonary capillaries through the thin walls of the alveoli. At the same time, carbon dioxide diffuses out of the pulmonary capillaries into the alveoli and then exhaled out of the body. The pulmonary veins return oxygenated blood to the left atria of the heart, which moves into the left ventricle where it is pumped out to the rest of the body via the aorta to the systemic arteries.
• Nutrients from the foods eaten are absorbed in the small intestine, where they diffuse into the systemic circulation and are transported to the liver through the hepatic portal vein and then throughout the rest of the body.
• Systemic arteries carry oxygenated blood to the liver where it mixes with the nutrient-rich blood coming in from the hepatic portal vein. Wastes and toxins are filtered out of the blood, bile is produced to help remove wastes and break down fats, medications are metabolized, and nutrients are broken down.
• Systemic arteries carry blood to the kidneys, where wastes are filtered out and urine is created.
• Endocrine glands scattered throughout the body release hormones into the bloodstream where they are transported to distant target cells.

Heart Rate

Heart rate (HART RĀT) (HR) is the number of heart beats per minute (bpm). HR can vary considerably among people based on their age, as well as their fitness level. For an adult, normal resting HR is 60–100 bpm. Although similar to the pulse, the heart rate is auscultated directly using a stethoscope and is a more accurate measurement than the pulse.[5]

Abnormal heart rates are referred to as bradycardia and tachycardia. Bradycardia (brād-i-KARD-ē-ă) refers to a slow heart rate, less than 60 bpm in an adult. Tachycardia (tak-ē-KARD-ē-ă) refers to a fast heart rate, greater than 100 bpm in an adult. Read more about bradycardia and tachycardia in the “Diseases and Disorders of the Cardiovascular System” section.

Pulse

Each time the heart pumps, ejecting blood forcefully into the circulation, the arteries expand and recoil to accommodate the surge of blood moving through them. This expansion and recoiling of the arterial wall are called the pulse (PULS) and allow for the measurement of heart rate. The pulse can be palpated manually by placing the tips of the fingers across an artery that runs close to the body surface, such as the radial artery (on the thumb side of the wrist) or the common carotid artery (in the neck).[6] These sites and other pulse sites are shown in Figure 9.8[7] below.

Figure 9.8

Pulse Sites

Both the rate and the strength of the pulse are important clinically. A high pulse rate can be temporarily caused by physical activity, but an extended fast or irregular pulse may indicate a heart condition. The pulse strength indicates the strength of ventricular contraction, cardiac output, and perfusion. Cardiac output (KAR-dē-ăk OUT-put) is the amount of blood pumped by the heart per minute. Perfusion (pĕr-FŪ-zhŏn) is the passage of blood through the blood vessels.[8]

If the pulse is strong, then cardiac output is high and perfusion to that site is good. If the pulse is weak, cardiac output is low or perfusion is impaired, and medical intervention may be warranted.

Cardiac Cycle

The period of time that begins with contraction of the atria, continues through ventricular contraction, and ends with ventricular relaxation is known as the cardiac cycle. The phase of the cardiac cycle when ventricles contract and eject blood is called systole (SIS-tŏ-lē). The phase of the cardiac cycle where the heart muscles relax, allowing the chambers to fill with blood, is called diastole (dī-AS-tŏ-lē).[9]

Blood Pressure

Blood pressure (BLŬD PRESH-ŭr) (BP) is the force of the blood against the vessel walls. In clinical practice, blood pressure is typically measured using a sphygmomanometer (sfĭg-mō-măn-ŎM-ĕt-ĕr), commonly called a blood pressure cuff. The cuff is placed over the brachial artery of the patient’s upper arm and inflated with air to temporarily occlude (ŏ-KLOOD) (block) blood flow and measure blood pressure. Blood pressure is recorded as a ratio of two numbers expressed as systolic pressure over diastolic pressure, measured in millimeters of mercury (mm Hg). For example, 120/80 mm Hg is a normal adult blood pressure. The systolic pressure is the higher value and reflects the arterial pressure resulting from the ejection of blood during ventricular contraction called systole. The diastolic pressure is the lower value and represents the arterial pressure of blood during ventricular relaxation called diastole.[10]

Low blood pressure, called hypotension (hī-pō-TEN-shŏn), has several causes, such as dehydration, vomiting, diarrhea, or medications used to treat hypertension. Treatment for hypotension typically includes fluid replacement. High blood pressure is called hypertension (hī-pĕr-TEN-shŏn) (HTN). Hypertension has a variety of causes, with risk factors such as obesity, lack of exercise, smoking, high salt diet, diabetes, and kidney disease.

References

1.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

2.

“2003​_Dual_System_of_Human_Circulation​.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

3.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

4.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

5.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

6.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

7.

“2110_Pulse_Sites​.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

8.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

9.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

10.

This work is a derivative of Anatomy and Physiology by OpenStax licensed under CC BY 4.0. Access for free at https://openstax​.org​/books/anatomy-and-physiology​/pages/1-introduction ↵.

Aneurysm

An aneurysm (AN-yŭ-rizm) is a dilation or bulging of a blood vessel caused by weakened vessel walls. Aneurysms can occur in vessels throughout the body but are more commonly found in arteries due to their increased pressure. Aneurysms can be caused by a variety of factors, including smoking, atherosclerosis (fatty plaque buildup in a vessel), and hypertension.[1] See Figure 9.9[2] for an illustration of thoracic and abdominal aneurysms.

Figure 9.9

Thoracic and Abdominal Aneurysms

Aneurysms are often asymptomatic and detected incidentally during diagnostic tests that are being done for other reasons. The force of blood pumping through the vessel with an aneurysm can split the layers of the artery wall, allowing blood to leak in between them, called a dissection. An aneurysm can burst completely, called a rupture, and cause severe, life-threatening bleeding. Aneurysms are managed with antihypertensive medications or may require surgical repair.[3]

Arrhythmia

A heart rhythm that follows the regular conduction system of the heart is called normal sinus rhythm (SĪ-nŭs RITH-ŭm). For example, bradycardia and tachycardia that occurs during normal sinus rhythm have abnormally slow or fast rates but have a regular rhythm.

• Bradycardia (brad-ē-KAR-dē-ă) refers to a slow resting heart rate of less than 60 beats per minute. A normal resting heart rate for an adult is 60 to 100 beats per minute (bpm). However, heart rates can vary widely among individuals based on several factors like age, fitness level, overall health, and medication side effects. Physically fit athletes may have a heart rate of 50 to 60 bpm at rest with no symptoms. However, individuals with bradycardia whose heart is not pumping enough blood to sufficiently supply the brain and body tissues with oxygen may have symptoms, such as feeling tired, dizzy, short of breath, or confused. Individuals with symptomatic bradycardia may experience syncope (SING-kŏ-pē), a medical term for a brief lapse in consciousness, commonly referred to as fainting. Bradycardia is a common side effect of many cardiac medications and can also be caused by several cardiac diseases and disorders. Treatment of symptomatic bradycardia includes medications to increase heart rate or surgical implantation of a pacemaker in the heart to maintain a normal heart rate.
• Tachycardia (tak-ē-KAR-dē-ă) is a rapid heart rate greater than 100 bpm. Tachycardia can be caused by stress, side effects of medications, and several medical conditions. When the heart beats too rapidly, its chambers do not have time to sufficiently fill with blood, resulting in a decreased amount of oxygenated blood being pumped to body tissues and organs. For this reason, symptoms of tachycardia are similar to symptoms of bradycardia. The individual may also have palpitations (pal-pĭ-TĀ-shŏnz), a sensation that the heart is racing, pounding, fluttering, or skipping a beat. Treatment is based on the underlying cause and may include medications or surgery.

Arrhythmia (ā-RITH-mē-ă) does not mean an absence of a heartbeat, but rather means the absence of a normal heart rhythm due to disrupted electrical activity of the conduction system. Examples of common arrhythmias are atrial fibrillation, heart block, ventricular tachycardia, and ventricular fibrillation.

• Atrial fibrillation (Ā-trē-ăl fĭb-rĭ-LĀ-shŏn) (A Fib) is characterized by atrial quivering instead of contracting. A Fib can cause a decrease in the volume of blood propelled with each heartbeat because the ventricles do not completely fill with blood before contracting. A Fib also increases the risk of a cerebrovascular accident (also known as a stroke).
• Heart block (härt blŏk) refers to a disruption in the normal conduction pathway of electrical signals through the atria and ventricles. Heart block can vary in severity from first-degree heart block, which is the least severe and often has no symptoms, to third-degree heart block that can be life-threatening. Symptoms of heart block may include bradycardia, missed heart beats, fatigue, dizziness, chest pain, and shortness of breath.
• Ventricular tachycardia (ven-TRĬK-yū-lăr tak-ĭ-KAR-dē-ă) (V Tach) refers to a very rapid heartbeat that originates in the ventricles. Ventricular fibrillation (ven-TRĬK-yū-lăr fĭb-rĭ-LĀ-shŏn) (V Fib) is a disorganized heart rhythm that causes the ventricles to quiver instead of contract. Ventricular tachycardia and ventricular fibrillation are life-threatening arrhythmias that require rapid emergency response and the use of a defibrillator to resolve the abnormal rhythm.

A defibrillator (dē-FIB-rĭ-lā-tŏr) is a device used by trained medical personnel who apply an electrical charge to the heart in an attempt to restart the SA node and establish a normal sinus rhythm. Automated external defibrillators (aw-tŏ-māt′-ĕd ĕks-tĕr′năl dē-fĭb′-rĭ-lā-tŏrs) (AEDs) are life-saving devices available in public areas to help individuals who are experiencing a cardiac arrest (KAR-dē-ăk ăr-REST) survive. Cardiac arrest is caused by arrhythmias that cause the heart to suddenly stop pumping blood. The average response time after calling 911 is 8 to 12 minutes, and for each minute defibrillation is delayed, the odds of survival are reduced by approximately 10%, so having access to an AED and knowing how to perform cardiopulmonary resuscitation (CPR) are critical. CPR refers to repeated compressions of the chest in an attempt to restore blood circulation following a cardiac arrest. While CPR is being performed, special pads are applied to the individual’s chest. The AED automatically analyzes the heart’s rhythm and, if indicated, delivers an electrical shock to help the heart reestablish an effective rhythm until paramedics arrive. See Figure 9.10[4] for an image of an AED.

Figure 9.10

Automatic External Defibrillator (AED)

Individuals who have experienced a cardiac arrest due to life-threatening arrhythmias may have an implantable cardioverter defibrillator (ĭm-plănt′-ă-bŭl kär′dē-ō-vûr′-tŏr dē-fĭb′-rĭ-lā-tŏr) (ICD) surgically placed in their chest. An ICD continuously analyzes the heart rhythm and provides an automatic electric shock to convert a dangerous heart rhythm to a normal heart rhythm.

Atherosclerosis

Atherosclerosis (ă-thĕr-ō-sklĕ-RO-sĭs) refers to hardening and narrowing of arteries due to the buildup of cholesterol and other fats called plaque within the lining of the arteries. Plaque creates inflammation and decreases the amount of blood flow through an artery, also referred to as decreased perfusion. Plaque can also grow so large that is causes a blockage of blood flow in the artery. When this accumulation of plaque occurs in the coronary arteries of the heart, it is called coronary artery disease (KOR-ŏ-nā-rē AR-tĕr-ē dĭ-ZĒZ) (CAD) or atherosclerotic heart disease. Read more information about coronary artery disease in a later subsection of this section. See Figure 9.11[5] for an illustration of the narrowing of a coronary artery by an atherosclerotic plaque.

Figure 9.11

Atherosclerotic Plaque

Cerebrovascular disease (sĕr′-brō-VAS-kyū-lăr dĭ-ZĒZ) (CVD) occurs when arteries in the brain or neck become thick, hard, or full of plaque and blood flow is restricted, which can cause a cerebrovascular accident (commonly known as a stroke). Peripheral artery disease (pĕr-IF-ĕr-ăl AR-tĕr-ē dĭ-ZĒZ) (PAD) occurs when blood vessels are obstructed in peripheral regions of the body, commonly causing pain during activity and possibly causing ulcers in the legs and feet.

A clinician may hear a bruit (brwē) when auscultating over an artery if atherosclerosis is present. A bruit sounds like an abnormal blowing, swishing sound. For example, a carotid bruit indicates the individual is at risk for a stroke.

Cardiomyopathy

Cardiomyopathy (kar-dē-ō-my-OP-ă-thē) refers to disease of the heart muscle. When cardiomyopathy occurs, the normal muscle in the heart can thicken, enlarge, stiffen, or thin out. As a result, the heart muscle’s ability to pump blood is reduced, which can lead to irregular heartbeats or the backup of blood into the lungs or rest of the body. Cardiomyopathy can be acquired (i.e., developed because of another disorder), inherited, or occur due to an unknown cause. Categories of cardiomyopathy include dilated, hypertrophic, and restrictive.[6] See Figure 9.12[7] for an illustration of common types of cardiomyopathy.

Figure 9.12

Categories of Cardiomyopathy

Congenital Heart Conditions

A congenital (kŏn-JĔN-ĭ-tăl) condition means it is present at birth. There are several types of congenital heart disorders. Some are caused by openings present in the heart that do not close as they should after birth. See Figure 9.13[8] for an illustration of common congenital cardiac disorders.

Figure 9.13

Examples of Congenital Heart Disorders

• Patent ductus arteriosus (PĀ-tĕnt DŬK-tŭs är-tēr′-ē-ō-sŭs) occurs when the ductus arteriosus fails to close after birth. The ductus arteriosus is a vessel in the fetal heart that connects the pulmonary trunk and aorta, bypassing the pulmonary circulation.
• Patent foramen ovale (PĀ-tĕnt fŏ-rā′-mĕn ō-vā′-lē) is a hole in the septum between the atria of the heart that does not close at birth.
• Coarctation (kō-ark-TĀ-shŏn) of the aorta is a narrowing of the aorta that forces the heart to pump harder to move blood through the aorta.
• Atrial septal defect (Ā-trē-ăl SĔP-tăl dĭ-FĔKT) (ASD) refers to an opening that exists in the septum (wall) between the left and right atria.
• Ventricular septal defect (ven-TRĬK-yū-lăr SĔP-tăl dĭ-FĔKT) (VSD) is an opening that exists in the septum (wall) between the left and right ventricles.

Tetralogy of Fallot (tĕt′ră-lō-jē ŏf fă-LŌ) is a serious congenital disorder with high mortality. It includes several abnormal conditions in the heart that allow unoxygenated blood from the right ventricle to flow into the left ventricle and mix with the blood that is relatively high in oxygen. Symptoms of Tetralogy of Fallot include a heart murmur, dyspnea, low blood oxygen saturation, clubbing of the fingers and toes, difficulty in eating, and failure to grow and develop. A murmur (MUR-mŭr) is an abnormal heart sound heard on auscultation by a stethoscope that may sound like a “whooshing” sound. Tetralogy of Fallot is diagnosed by echocardiography. Treatment involves extensive surgical repair.[9]

Coronary Artery Disease

Coronary artery disease (KOR-ŏ-nā-rē AR-tĕr-ē dĭ-ZĒZ) (CAD) occurs when atherosclerosis (i.e., buildup of plaque) in the coronary arteries obstructs the flow of oxygenated blood to the heart muscle. As oxygenated blood flow to the cardiac muscle cells is reduced, referred to as ischemia (ĭs-KEE-mē-ă), individuals often experience chest pain called angina (an-JĪ-nă). See Figure 9.14[10] for an image of a blockage of coronary arteries on an angiogram.

Figure 9.14

Angiogram of Atherosclerotic Coronary Arteries

CAD is progressive and, if left untreated, can cause a myocardial infarction (MI). Risk factors include smoking, family history, hypertension, obesity, diabetes, lack of physical activity, stress, hyperlipidemia, and excessive alcohol use. Treatments may include medication, changes to diet and exercise, angioplasty with insertion of a stent, or coronary artery bypass graft (CABG).[11] Read more about these procedures in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Cardiovascular System” section.

Deep Vein Thrombosis

A deep vein thrombosis (dēp vān THROM-bō-sĭs) (DVT) is a blood clot in a deep vein that most often occurs in the lower extremities. DVTs can break free and become life-threatening emboli that travel to other areas of the body and cause blockages. For example, a pulmonary embolus (PE) is a medical emergency caused by a DVT that became an embolus and lodged in the lung.

Symptoms of a DVT often include calf pain in one leg with swelling, redness, and warmth of that leg. A DVT is diagnosed with a Doppler ultrasound that identifies altered blood flow in a vessel due to a clot.[12]

Edema

Despite the presence of valves within veins that prevent the backflow of blood, over the course of a day, some blood will inevitably pool in the lower limbs, due to the pull of gravity. Any blood that accumulates in a vein will increase the pressure within it. Increased pressure will promote the flow of fluids out of the capillaries and into the interstitial fluid. The presence of excess tissue fluid around the cells leads to a condition called edema (e-DĒ-ma). Medications, such as diuretics, and compression stockings are used to help minimize the edema. See Figure 9.15[13] for an image of a patient with edema.

Figure 9.15

Edema

Heart Failure

Heart failure (HART FĀL-yŭr) (HF) occurs when the heart loses its effectiveness in pumping blood. When the heart is not pumping effectively, symptoms of fatigue, shortness of breath, edema, or lung congestion can occur. Chronic HF is a progressive disorder that can be represented on a continuum. The continuum ranges from individuals who are at risk for HF but are asymptomatic, to individuals who have end-stage heart failure and require end-of-life care. Treatments may include medication, a low sodium diet, and fluid restrictions.[14] See Figure 9.16[15] for an illustration of common symptoms of heart failure.

Figure 9.16

Heart Failure

There are many potential causes of HF, including coronary artery disease (CAD), myocardial infarction (MI), hypertension, valve disorders, and cardiomyopathy. Treatment for heart failure may include medications to eliminate excess fluid, a low salt diet, fluid restrictions, implanted devices that assist the heart to pump blood, and heart transplant surgery.[16]

Hypertension

Hypertension (hī-pĕr-TEN-shŏn) refers to elevated blood pressure greater than 120/80 mm Hg in an adult. Hypertension is very common, affecting millions of individuals worldwide. See Figure 9.17[17] for an image of a sphygmomanometer (sfig-mō-mă-NOM-ĕt-ĕr) used to obtain blood pressure readings.

Figure 9.17

Sphygmomanometer

Risk factors for developing hypertension include age, ethnicity, family history, and lifestyle factors. Individuals with obesity, diets high in sodium, excessive alcohol intake, chronic stress, and limited physical activity are at higher risk for developing hypertension. Many people with hypertension do not have symptoms, so they are unaware they have the disorder until a complication like a myocardial infarction, stroke, or heart failure occurs. Treatment includes medications and healthy lifestyle changes like adopting a heart-healthy diet, exercising regularly, stopping smoking, getting good sleep, losing weight, and managing stress.[18]

Myocardial Infarction

Myocardial infarction (mī-ŏ-kar′dē-ăl in-FARK-shŏn) (MI), commonly called a heart attack, is caused by blockage of blood flow to the heart tissue, resulting in death of the cardiac muscle cells. Acute coronary syndrome (ə-KYŪT KOR-ŏ-nā-rē SĬN-drōm) (ACS) is a general term used for medical situations in which blood supplied to the heart muscle is suddenly insufficient. An MI is commonly caused by atherosclerosis causing a blockage in a coronary artery. It can also occur when a piece of an atherosclerotic plaque breaks off and travels through the coronary arterial system until it lodges in one of the smaller vessels. See Figure 9.18[19] for a depiction of an individual experiencing an MI and the damage occurring to the cardiac muscle as a result of the coronary artery blockage.

Figure 9.18

Myocardial Infarction

A classic symptom of an MI includes sudden crushing pain beneath the sternum called angina (an-JĪ-nă) that may radiate down the left arm. Individuals often describe angina as “it feels as if something is sitting on my chest.” Other common symptoms include dyspnea, diaphoresis, nausea, and light-headedness. Diaphoresis (dī-ă-fŏ-RĒ-sĭs) means profuse (excessive) sweating. However, females may not experience these symptoms and only have a feeling similar to indigestion.[20]

An MI is a medical emergency. The faster the response, the more cardiac muscle cells that can be saved, so anyone who is suspected of having an MI should call 911. An MI is diagnosed with an electrocardiogram (ē-lĕk-trō-KĂR-dē-ō-grăm) (ECG) and blood tests called cardiac enzymes. Cardiac enzymes include creatine kinase and cardiac troponin, both of which are released by damaged cardiac muscle cells.[21]

Immediate treatment typically includes administration of oxygen, aspirin (to stop the plaque from growing), and a medication called nitroglycerin (to help dilate the blood vessels to get more oxygenated blood to the cardiac muscle). Based on the results of the ECG and cardiac enzyme tests, the individual may undergo thrombolysis (thrŏm-BOL-ĭ-sĭs), a procedure that involves administering a clot-dissolving medication to restore blood flow in a coronary artery. An alternative to thrombolysis is angioplasty (AN-jee-ō-plas-tē) or coronary artery bypass graft surgery (KOR-ŏ-nā-rē AR-tĕr-ē bī-păs graft Sŭr-jĕr-ē) (CABG). Read more about these procedures in the “Medical Specialists, Diagnostic Testing, and Procedures Related to Cardiovascular System” section of this chapter.[22]

Valvular Heart Disease

The heart has four valves that open and close at specific times during the cardiac cycle to control or regulate the blood flowing into and out of the heart. See Figure 9.19[23] for an illustration of the heart valves including the tricuspid, pulmonary, mitral, and aortic. Three of the heart valves (tricuspid, pulmonary, and aortic valves) are composed of three leaflets or flaps that work together to open and close to allow blood to flow forward and not backwards through the opening. The mitral valve (also known as the bicuspid valve) only has two flaps that open and close.

Figure 9.19

Heart Valves

Healthy heart valves fully open and close during the heartbeat, but patients with valvular heart disease (văl′-vyū-lăr härt dĭ-zēz′) have diseased valves that do not fully open and close. Diseased valves that become “leaky” and don’t completely close cause a condition called regurgitation (rē-gŭr′-jĭ-tā′-shŭn). When regurgitation occurs, blood flows backwards and not enough blood is pushed forward through the heart. Aortic insufficiency (ā-OR-tĭk in-sŭ-FISH-ĕn-sē) (AI) is a valvular heart disease that occurs when the aortic valve does not close properly and allows regurgitation of blood back into the left ventricle.

Another type of valve disorder occurs when the opening of the valve is narrowed and stiff, causing it to not open fully when blood is trying to pass through. This disorder is called stenosis (stĕ-NŌ-sĭs).[24]

There are several causes of valvular heart disease, including congenital heart conditions, infections, degenerative conditions (i.e., they wear out with age), and conditions linked to other types of heart disease. A murmur (MUR-mŭr), an abnormal heart sound heard on auscultation by a stethoscope, is a classic sign of a valvular heart disorder. Other symptoms include shortness of breath, chest pain, fatigue, dizziness, and palpitations.[25]

Valvular heart disease is diagnosed by echocardiography. Treatment may include medications to treat the symptoms or surgery to repair or replace the valves.[26] Read more about these procedures in the “Medical Specialists, Diagnostic Testing, and Procedures Related to the Cardiovascular System.”

Varicose Veins

Varicose veins (VAR-i-kōs VĀNZ) are a common condition caused by weak or damaged vein walls and valves. Veins have one-way valves that open and close to keep blood flowing toward the heart. Weak or damaged valves or walls in the veins can cause blood to pool and even flow backward.[27] See Figure 9.20[28] for an image of varicose veins.

Figure 9.20

Varicose Veins

Symptoms include bulging, bluish veins, and a feeling of heaviness or discomfort in the legs and feet. Without treatment, they tend to grow worse over time. The use of compression stockings (commonly known as TED hose), as well as elevating the feet and legs whenever possible, may be helpful in alleviating the symptoms of varicose veins. However, severe cases may require resolution through medical procedures.[29]

Procedures used to treat varicose veins include the following[30]:

• Endovenous laser ablation (ĕn′-dō-vē′-nŭs lā′-zŏr ăb-lā′-shŭn) to close off a varicose vein. A health care provider uses laser or radiofrequency energy to heat the inside of the vein and close it off.
• Sclerotherapy (sklĕr-ō-THER-ă-pē) to seal off a varicose vein. The health care provider injects liquid or foam chemicals into the vein to create a plug that seals it shut.
• Phlebectomy (flĕ-BĔK-tŏ-mē) to remove small varicose veins. The health care provider makes small cuts to remove smaller veins near the skin.
• Surgery to tie off and remove large varicose veins in a procedure called vein ligation or stripping.

References

1.

Centers for Disease Control and Prevention. (2021, September 27). Aortic aneurysm. Department of Health & Human Services. https://www​.cdc.gov/heartdisease​/aortic_aneurysm.htm ↵.

2.

“Aortic_aneurysm​.jpg” by en:National Institutes of Health is licensed in the Public Domain. ↵.

3.

Centers for Disease Control and Prevention. (2021, September 27). Aortic aneurysm. Department of Health & Human Services. https://www​.cdc.gov/heartdisease​/aortic_aneurysm.htm ↵.

4.

“Saver_One_AED​.jpg” by unknown author via Error! Hyperlink reference not valid. is licensed under CC BY 4.0 ↵.

5.

“Blausen​_0259_CoronaryArteryDisease_02​.png” by Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014.” WikiJournal of Medicine is licensed under CC BY 3.0 ↵.

6.

Centers for Disease Control and Prevention. (2023, February 21). Cardiomyopathy. Department of Health & Human Services. https://www​.cdc.gov/heartdisease​/cardiomyopathy.htm ↵.

7.

“Major​_categories_of_cardiomyopathy.png” by Npatchett is licensed under CC BY-SA 4.0 ↵.

8.

“2009​_Congenital_Heart_Defects.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

9.

This work is a derivative of Anatomy & Physiology by OpenStax and is licensed under CC BY 4.0. Access for free at https://openstax​.org​/details/books/anatomy-and-physiology-2e ↵.

10.

“2016​_Occluded_Coronay_Arteries.jpg” by OpenStax College is licensed under CC BY 3.0 ↵.

11.

Centers for Disease Control and Prevention. (2023, May 15). About heart disease. Department of Health & Human Services. https://www​.cdc.gov/heartdisease/about​.htm ↵.

12.

This work is a derivative of StatPearls by Baker, Anjum, & dela Cruz and is licensed under CC BY 4.0 ↵.

13.

“Combinpedal​.jpg” by James Heilman, MD is licensed under CC BY-SA 3.0 ↵.

14.

Centers for Disease Control and Prevention. (2023, April 14). Heart disease. Department of Health & Human Services. https://www​.cdc.gov/heartdisease/about​.htm ↵.

15.

“Heartfailure​.jpg” by National Heart, Lung, and Blood Institute, National Institutes of Health is licensed in the Public Domain. ↵.

16.

Centers for Disease Control and Prevention. (2023, April 14). Heart disease. Department of Health & Human Services. https://www​.cdc.gov/heartdisease/about​.htm ↵.

17.

“Grade​_1_hypertension.jpg” by Steven Fruitsmaak is licensed under CC BY 3.0 ↵.

18.

National Heart, Lung, and Blood Institute. (2022, March 24). What is high blood pressure. National Institutes of Health. https://www​.nhlbi.nih​.gov/health/high-blood-pressure ↵.

19.

“Depiction​_of_a_person​_suffering_from_a_heart​_attack_(Myocardial_Infarction).png” by https://www​.myupchar.com/en is licensed under CC BY-SA 4.0 ↵.

20.

American Heart Association. (n.d.). Heart attack. https://www​.heart.org​/en/health-topics/heart-attack ↵.

21.

American Heart Association. (n.d.). Heart attack. https://www​.heart.org​/en/health-topics/heart-attack ↵.

22.

American Heart Association. (n.d.). Heart attack. https://www​.heart.org​/en/health-topics/heart-attack ↵.

23.

“Diagram​_of_the_human_heart_(cropped).svg” by Wapcaplet is licensed under CC BY 3.0 ↵.

24.

Centers for Disease Control and Prevention. (2019, December 9). Valvular heart disease. Department of Health & Human Services. https://www​.cdc.gov/heartdisease​/valvular_disease.htm ↵.

25.

Centers for Disease Control and Prevention. (2019, December 9). Valvular heart disease. Department of Health & Human Services. https://www​.cdc.gov/heartdisease​/valvular_disease.htm ↵.

26.

Centers for Disease Control and Prevention. (2019, December 9). Valvular heart disease. Department of Health & Human Services. https://www​.cdc.gov/heartdisease​/valvular_disease.htm ↵.

27.

National Heart, Lung, and Blood Institute. (2023). Varicose veins. https://www​.nhlbi.nih​.gov/health/varicose-veins ↵.

28.

“Varicose_ASV1​.jpg” by Nini00 is licensed under CC BY-SA 3.0 ↵.

29.

National Heart, Lung, and Blood Institute. (2023). Varicose veins. https://www​.nhlbi.nih​.gov/health/varicose-veins ↵.

30.

National Heart, Lung, and Blood Institute. (2023). Varicose veins. https://www​.nhlbi.nih​.gov/health/varicose-veins ↵.

Medical Specialists

Cardiology (kăr-dē-ŏl′ō-jē) is the study of the heart. Specialty roles related to cardiology include cardiologists, cardiovascular surgeons, electrophysiologists, cardiovascular technologists and technicians, cardiovascular perfusionists, cardiac care nurses, cardiology nurse practitioners, and cardiology physician assistants.

Cardiologists

A cardiologist (kar-dē-OL-ŏ-jĭst) is a physician who specializes in the diagnosis and treatment of heart disease. Cardiovascular surgeons surgically treat heart disorders. An electrophysiologist is a physician who specializes in the diagnosis and treatment of issues related to the heart’s electrical conduction system.

Vascular Surgeon

Vascular surgery includes repair and replacement of diseased or damaged blood vessels, removal of plaque from vessels, and insertion of venous catheters, and traditional surgery.[1]

Vascular Sonographer

Vascular sonographers use ultrasound machines to produce images of patients’ veins and arteries using high-frequency sound waves. Physicians use these images that show the movement of blood through vessels to diagnose and treat various conditions.[2]

Cardiovascular Technologists and Technicians

Cardiovascular technologists and technicians perform cardiovascular diagnostic tests and procedures such as electrocardiography, stress testing, Holter monitor testing, ambulatory blood pressure (BP) testing, and pacemaker monitoring.

Cardiovascular Perfusionist

Cardiovascular perfusionists operate circulation equipment that artificially support or temporarily replace a patient’s circulatory or respiratory function. An example of such equipment is a heart-lung machine used during some types of coronary artery bypass surgery.

Cardiac Care Nurses

Cardiac care nurses provide care for patients with a variety of heart diseases or conditions in a cardiac care unit (CCU) in hospitals. They administer heart medications, help patients recover from heart surgery, or perform emergency care like assisting in defibrillation.

Cardiology Nurse Practitioners

Cardiology nurse practitioners (NPs) are registered nurses with advanced education and clinical experience to provide care for patients with chronic and acute cardiac diseases. Many cardiology NPs work in private practices, in-patient hospitals, outpatient clinic settings, or multiple practice settings where they assess the health status of patients, prescribe pharmacological and nonpharmacological treatments, and collaborate with an interdisciplinary team.

Cardiology Physician Assistants

Cardiology physician assistants (PAs) work in collaboration with cardiologists and cardiovascular surgeons. They provide a broad range of medical care to patients with varied clinical duties depending on the subspecialty and setting. PAs take medical histories, perform physical examinations, order and interpret laboratory and diagnostic tests, diagnose illness, develop and manage treatment plans for their patients, prescribe medications, perform procedures, and assist in surgery.

Radiology Technologist

A radiology technologist (rā-dē-ŎL-ŏ-jē tĕk-nŎL-ŏ-jĭst), commonly called an X-ray tech, is a health care professional who is specially trained to perform medical imaging like X-rays, CT scans, MRIs, and PET scans. To become a radiology technologist or MRI technologist, a person completes an associate degree and passes a certification exam.

Diagnostic Testing

Cardiac Catheterization and Angiogram

Cardiac catheterization (kär′dē-ăk kăth-ĕ-tĕr-ĭ-ZĀ-shŏn) is a valuable diagnostic procedure in the evaluation and management of cardiovascular disorders. Cardiac catheterization, performed in association with a coronary angiogram, is a diagnostic procedure used to visualize the coronary arteries, heart chambers, and great vessels. It involves the insertion of a thin, flexible tube (catheter) into the blood vessels, usually through the femoral or radial artery, to access the inside of the heart and its surrounding structures.

During a coronary angiogram (KOR-ŏ-nā-rē AN-jee-ō-gram), dye is injected into the blood vessels of the heart, and then a series of X-ray images (angiograms) are taken to view the coronary arteries. If a blockage is discovered, an angioplasty can be performed. Read more about angioplasty under the “Procedures” subsection later in this section.

See Figure 9.21[3] for an image of a cardiac catheterization procedure showing the image of the patient’s coronary arteries and heart chambers displayed on the monitor during the angiogram.

Figure 9.21

Angiogram and Cardiac Catheterization

Cardiac Stress Test

A cardiac stress test (kär′-dē-ăk strĕs tĕst), also known as an exercise stress test or treadmill test, is a diagnostic procedure used to evaluate the performance and function of the heart during physical activity. It helps identify potential heart problems, such as coronary artery disease (CAD), arrhythmias, and heart valve issues. During a cardiac stress test procedure, a patient is asked to walk on a treadmill or pedal a stationary bicycle to evaluate the heart’s function during strenuous activity. In patient circumstances where walking on a treadmill is not appropriate, medication is administered intravenously to mimic the stress on the heart induced by exercise, referred to as a chemical stress test. See Figure 9.22[4] for an image of a cardiac stress test.

Figure 9.22

Cardiac Stress Testing

Electrocardiogram

An electrocardiogram (ē-lĕk-trō-KĂR-dē-ō-grăm) (EKG or ECG) is a diagnostic test that records the electrical activity of the heart. It is performed to diagnose a myocardial infarction (MI) or cardiac rhythm abnormalities. See Figure 9.23[5] for an image of a patient undergoing an ECG.

Figure 9.23

ECG Test

During an ECG, surface electrodes are placed on specific anatomical sites on the body to record electrical activity. An example of a 12-lead ECG is presented in Figure 9.24.[6]

Figure 9.24

ECG Reading

Holter Monitor

A Holter monitor (HOL-tĕr MON-ĭ-tŏr) is a portable device that continuously records a patient’s heart rhythm and electrical activity over an extended period, typically 24 to 48 hours. See Figure 9.25[8] for an illustration of a Holter monitor. Its primary purpose is to detect and document irregularities in the heart’s electrical patterns, such as arrhythmias, which may not be captured during brief in-office ECGs. Additionally, patients may activate a trigger on a Holter device to denote the occurrence of cardiac symptoms, such as increased shortness of breath, fatigue, or dizziness. A cardiologist reviews ECG tracings to identify arrhythmias.

Figure 9.25

Holter Monitor

Procedures

Angioplasty

During a cardiac catheterization, if a blockage is found, an angioplasty (AN-jee-ō-plas-tē) may be performed, also referred to as a percutaneous transluminal coronary angioplasty (pĕr-kyū-TĀ-nē-ŭs trăns-LOO-mĭ-năl KOR-ŏ-nā-rē AN-jee-ō-plas-tē) (PTCA). During an angioplasty, a catheter with a balloon at the tip is inserted into the narrowed coronary artery. The balloon is inflated to widen the artery and improve blood flow. A small mesh device, known as a stent, is often inserted to help keep the coronary artery open after the procedure is completed. See Figure 9.26[11] for an illustration of an angioplasty with stent placement.

Figure 9.26

Angioplasty with Stent Placement

Coronary Artery Bypass Surgery

Coronary artery bypass (KOR-ŏ-nā-rē AR-tĕr-ē bī-păs) surgery, also called coronary artery bypass graft (KOR-ŏ-nā-rē AR-tĕr-ē bī-păs graft) (CABG), creates a new path for blood to flow around a blocked or partially blocked coronary artery. The surgery involves taking a healthy blood vessel, often from the chest or leg area, and connecting it underneath the blocked artery to improve blood flow to heart muscle. During surgery, a heart-lung machine may be used to artificially keep oxygenated blood flowing through the patient’s body. CABG doesn’t cure the heart disease, but it can reduce symptoms and may reduce the risk of heart disease-related death.[12] See Figure 9.27[13] for an illustration of a CABG.

Figure 9.27

Coronary Artery Bypass Surgery

Heart Transplant

A heart transplant (härt trăns′-plănt) replaces a patient’s failing heart with a donor heart. The failing heart may be a result of end-stage heart failure, arrhythmias, a congenital heart condition, or other severe heart condition. A healthy heart is donated via organ donation from someone who died. During the transplant procedure, the surgeon removes the patient’s failing heart and then connects the donor heart by sewing together the recipient’s and donor vena cavae, aorta, pulmonary artery, and left atrium. In patients with congenital heart disease, the surgeon might also transplant the lungs with the heart. For the rest of the patient’s life, they are prescribed immunosuppressive and other medications to prevent their body from rejecting the donated heart.[14] See Figure 9.28[15] for an illustration of a heart transplant.

Figure 9.28

Heart Transplant

Pericardiocentesis

Pericardiocentesis (per-ĭ-kar-dē-ō-sen-TĒ-sĭs) is a procedure that involves draining fluid from the pericardial sac around the heart. It involves the cardiologist inserting a needle into the patient’s chest until the tip of the needle is inside the pericardium and then draining fluid or placing a drain that can remove fluid slowly over time. Before inserting the needle, the physician and the imaging technician use ultrasound guidance via an echocardiogram to help insert the needle at the specific point needed and prevent injury to the heart.[16] See Figure 9.29[17] for an illustration of pericardiocentesis.

Figure 9.29

Pericardiocentesis

Valvuloplasty

A valvuloplasty (val-VŪ-lō-plas-tē) is a procedure performed by a cardiovascular surgeon to repair a heart valve that has a narrowed opening, referred to as stenosis. Valvuloplasty is performed during a cardiac catheterization. Similar to an angioplasty, a soft, thin tube with a balloon at the tip is inserted into a blood vessel, usually in the groin. The catheter is carefully guided to the narrowed valve in the heart. Once in position, the balloon is inflated to widen the valve, improving blood flow. The balloon is then deflated, and the catheter with balloon is removed.[18] See Figure 9.30[19] for an illustration of a valvuloplasty on the aortic valve.

Figure 9.30

Valvuloplasty

Valve Replacement

If a malfunctioning heart valve can’t be repaired, the valve may be surgically replaced, referred to as a valve replacement (vălv rē-plās′-mĕnt). The cardiovascular surgeon removes the heart valve and replaces it with a mechanical valve, or a valve made from cow, pig, or human heart tissue (called a biological valve). Biological valves often need to be replaced because they break down over time. Mechanical valves are more durable but require the patient to take blood-thinning medications for the rest of their life to prevent blood clots.[20] See Figure 9.31[21] for an illustration of valve replacement with a mechanical valve.

Figure 9.31

Valve Replacement With a Mechanical Valve

References

1.

Society for Vascular Surgery. (2023). What is a vascular surgeon? https://vascular​.org​/patients-and-referring-physicians​/common-questions​/what-vascular-surgeon ↵.

2.

American Registry of Radiologic Technologists. (n.d). Vascular sonography. https://www​.arrt.org​/pages/earn-arrt-credentials​/credential-options​/vascular-sonography ↵.

3.

"A​_cardiac_catheterization​_procedure_in_the​_Naval_Medical_Center​_San_Diego_hospital’s​_cardiac​_catheterization_laboratory.jpg” by Navy Medicine is licensed in the Public Domain. ↵.

4.

“a-cardiologist-examining-a-patient-undergoing-cardiac-stress-test-8460228” by Los Muertos Crew via Pexels is licensed under CC0. ↵.

5.

“ambulance-emergency-medic-health-3592155” by OsloMetX via pixabay is licensed under CC0 ↵.

6.

“12_lead_ECG​.jpg” by Peterhcharlton is licensed under CC BY 4.0 ↵.

7.

Johns Hopkins Medicine. (n.d.). Echocardiogram. https://www​.hopkinsmedicine​.org/health/treatment-tests-and-therapies​/echocardiogram ↵.

8.

“Holter_Monitor​.png” by BruceBlaus is licensed under CC BY-SA 4.0 ↵.

9.

Mayo Clinic. (2022, July 27). SPECT scan. https://www​.mayoclinic​.org/tests-procedures​/spect-scan/about/pac-20384925 ↵.

10.

Mayo Clinic. (2022, February 22). Cardiac ablation. https://www​.mayoclinic​.org/tests-procedures​/cardiac-ablation/about/pac-20384993 ↵.

11.

“Angioplasty​_-_Balloon​_Inflated_with_Stent.png” by BruceBlaus is licensed under CC BY-SA 4.0 ↵.

12.

Mayo Clinic. (2022, December 3). Coronary artery bypass surgery. https://www​.mayoclinic​.org/tests-procedures​/coronary-bypass-surgery​/about/pac-20384589 ↵.

13.

“Coronary​_Artery_Bypass_Surgery.jpg” by BruceBlaus is licensed under CC BY-SA 4.0 ↵.

14.

American Heart Association. (2023, September 19). Heart transplant. https://www​.heart.org​/en/health-topics/congenital-heart-defects​/care-and-treatment-for-congenital-heart-defects​/heart-transplant ↵.

15.

“Heart_transplant​.jpg” by D Dinneen~commonswiki is licensed under CC BY-SA 3.0 ↵.

16.

Cleveland Clinic. (2022, February 26). Pericardiocentesis. https://my​.clevelandclinic​.org/health/treatments​/22613-pericardiocentesis ↵.

17.

“Pericardiocentesis​.jpg” by Npatchett is licensed under CC BY-SA 4.0 ↵.

18.

Mayo Clinic. (2022, March 18). Valvuloplasty. https://www​.mayoclinic​.org/tests-procedures​/valvuloplasty/pyc-20384961 ↵.

19.

“Valvuloplasty​_Aortic.png” by BruceBlaus is licensed under CC BY-SA 4.0 ↵.

20.

Mayo Clinic. (2022, December 14). Heart valve surgery. https://www​.mayoclinic​.org/tests-procedures​/heart-valve-surgery​/about/pac-20384901 ↵.

21.

“Blausen​_0056_ArtificialHeartValve.png” by BruceBlaus is licensed under CC BY 3.0 ↵.