Heart under cardio

• Cardiovascular system


  Consists of the heart and the central blood vessels (primarily the pulmonary, coronary, and neck arteries and veins)
• Peripheral vascular system


  Includes those arteries and veins distal to the central vessels, extending all the way to the brain and to the extremities
• Nurses assess the heart

  1. Inspection

  2. Palpation

  3. Auscultation
• The heart is usually assessed during an initial physical assessment; periodic reassessments may be necessary for long-term or at-risk clients or those with cardiac problems
• Point of maximal impulse (PMI)


  The point where the apex touches the anterior chest wall and heart movements are most easily observed and palpated
• Precordium


  • The area of the chest overlying the heart
  • Inspected and palpated for the presence of abnormal pulsations or lifts or heaves
• Lift


  A rising along the sternal border with each heartbeat, occurs when cardiac action is very forceful
• Heave


  A rising along the sternal border with each heartbeat, often used interchangeably with lift
• Enlargement or overactivity of the left ventricle

  Produces a heave lateral to the apex
• Enlargement of the right ventricle

  Produces a heave at or near the sternum
• First heart sound (S1)


  Occurs when the atrioventricular (AV) valves close, a dull, low-pitched sound described as "lub"
• Second heart sound (S2)


  Occurs when the semilunar valves close, a higher pitch than S1 and shorter in duration, described as "dub"
• Systole


  The period in which the ventricles contract, begins with S1 and ends at S2
• Diastole


  The period in which the ventricles relax, starts with S2 and ends at the subsequent S1
• S3 sound


  Occurs early in diastole right after S2, low in pitch, heard best at the apex, sounds like "lub-dub-ee" or "Kentuc-ky", often disappears when the client sits up, normal in children and young adults but may indicate heart failure in older adults
• S4 sound


  Occurs near the very end of diastole just before S1, low in pitch, heard best at the apex, creates the sound of "dee-lub-dub" or "Ten-nessee", may be heard in older clients and can be a sign of hypertension
• Normal heart sounds


  • S1
  • S2
  • Systole
  • Diastole
• The nurse may also hear abnormal heart sounds, such as clicks, rubs, and murmurs, which are caused by valve disorders or impaired blood flow within the heart and require advanced training to diagnose
• The heart is divided into four chambers, including the right atrium (RA), left atrium (LA), right ventricle (RV), and left ventricle (LV).
• S2 and S2 can be heard at

  PRECORDIAL AREA
• Abnormal Sound that can heard in the heart

  Clicks, rub and murmur
• S1 and S2 can also be heard in 4 areas

  aorta area , pulmonary area, tricuspid area, mitral area,