The Cardiovascular System

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

Preface viii

Acknowledgements x

1 Anatomy and Physiology: The Cardiovascular System 1

Blood 1

Blood Vessels 6

Heart 10

Conclusion 20

Glossary of Terms 20

Multiple Choice Questions 21

References 23

2 Cardiovascular Assessment 24

The Importance of Cardiovascular Assessment 24

Assessing Needs 25

Chief Complaint and History of Present Condition 27

Family History 27

Lifestyle 28

Past Medical History 28

Physical Examination 28

Palpation 29

The Blood Pressure 33

Chest Examination 34

Electrocardiogram 36

Assessing Chest Pain 39

Conclusion 42

Glossary of Terms 42

Multiple Choice Questions 43

References 44

3 Myocardial Infarction 46

Pathophysiological Changes Associated with Myocardial Infarction 46

Epidemiology 48

Risk Factors 50

Clinical Presentation 51

Clinical Investigations 53

Diagnosis 53

Management 53

Reperfusion 54

Health Teaching 56

Conclusion 57

Glossary of Terms 58

Multiple Choice Questions 59

References 60

4 Heart Failure 62

Pathophysiological Changes Associated with Heart Failure 62

Epidemiology 67

Risk Factors 67

Clinical Presentation 68

Clinical Investigations and Diagnosis 70

Management 72

End of Life Care 73

Health Teaching 73

Conclusion 74

Glossary of Terms 75

Multiple Choice Questions 76

References 77

5 Cardiogenic Shock 79

Cardiac Arrest 79

Epidemiology: Cardiac Arrest 80

Risk Factors Associated with Cardiac Arrest 81

Guidelines for Adult Basic Life Support 81

Shock 83

Shock: Signs and Symptoms 86

Pathophysiological Changes Associated with Cardiogenic Shock 86

Epidemiology 87

Risk Factors 88

Clinical Presentation 89

Clinical Investigations and Diagnosis 89

Potential Investigations 89

Management 90

Health Teaching 90

Conclusion 92

Glossary of Terms 92

Multiple Choice Question 93

References 94

6 Angina 96

Stable Angina 96

Silent Angina 97

Prinzmetal’s Angina 98

Microvascular Angina 98

Pathophysiological Changes Associated with Angina 99

Epidemiology 101

Risk Factors 101

Clinical Presentation 103

Clinical Investigations and Diagnosis 103

Management 104

Other Interventions 107

Health Teaching 107

Conclusion 108

Glossary of Terms 109

Multiple Choice Questions 110

References 111

7 Hypertension 113

Primary and Secondary Hypertension 113

Blood Pressure 113

The Cardiac Cycle 115

Pathophysiological Changes Associated with Hypertension 116

Epidemiology 116

Risk Factors 116

Non-modifiable Risk Factors 116

Modifiable Risk Factors 117

Clinical Presentation 118

Blood Pressure Measurement 120

White Coat Syndrome 121

Clinical Investigations and Diagnosis 122

Management 122

Health Teaching 124

Conclusion 124

Glossary of Terms 125

Multiple Choice Questions 126

References 127

8 Peripheral Arterial Disease 128

Pathophysiological Changes Associated with PAD 128

Epidemiology 130

Risk Factors 130

Clinical Presentation 131

Clinical Investigations and Diagnosis 131

Management 133

Pharmacological Interventions 134

Surgical and Radiological Interventions 135

Amputation 135

Prognosis 136

Health Teaching 136

Conclusion 138

Glossary of Terms 138

Multiple Choice Questions 139

References 140

MCQ Answers 142

Index 143