Acyanotic heart disease diagnosis | Circulatory System and Disease | NCLEX-RN | Khan Academy
Acyanotic heart disease diagnosis | Circulatory System and Disease | NCLEX-RN | Khan Academy
How do we know a patient has an acyanotic heart disease? Learn how health care professionals use a variety of tools to diagnosis these conditions, such as stethoscopes, chest x-rays, echocardiogram, and electrocardiograms (ECG or EKG). Created by Leslie Samuel.
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Content
2.164 -> Voiceover: With
non-cyanotic heart dieseae,
3.847 -> you have some type of a congenital defect.
7.273 -> Congenital just means that the
individual is born with it,
10.271 -> but what happens as a
result is that blood moves
14.025 -> from the left side of the heart
to the right side of the heart.
17.641 -> In this example, you see that
we have a little hole here in
21.531 -> the wall between the left
ventricle and the right ventricle.
24.513 -> Since the pressure is
higher on this left side
28.213 -> that's sending the blood
throughout the entire body,
30.828 -> that is going to cause
blood to go from the left
34.301 -> to the right ventricle.
36.854 -> Now, my question is, how
does the doctor diagnose
40.652 -> that an individual has some
non-cyanotic heart defect?
44.366 -> Well, one of the first things
is that you can hear it.
48.4 -> So, let's draw a little ear here.
52.181 -> You'll be able to hear it,
54.018 -> and also, you should be able see it.
58.736 -> We'll talk about how you
can do those things ...
62.047 -> let's put a little pupil here.
64.209 -> All right, so, you'll be able to hear it,
65.387 -> and you'll be able to see it.
66.649 -> Now for the hearing, well,
just think about it this way.
69.668 -> Let's say you have a garden hose.
71.941 -> This is my garden hose,
73.404 -> and we have water that's flowing
through that garden hose,
77.448 -> and all of a sudden, we decide
79.531 -> "Hey we're going to put a
little tiny hole in the hose."
85.061 -> So, right here we have a little hole.
87.932 -> What's going to happen?
88.841 -> Well, of course, you're going
to have water flying out
91.918 -> in places that you don't want it to go,
93.917 -> and it's going to kind of
squirt in this direction.
96.119 -> If you come closely here,
you'll be able to hear that.
98.922 -> Right? Yeah! Of course, that makes sense.
100.781 -> Well, how does a doctor do that?
102.167 -> Well, the doctor can't go in and
105.084 -> put his ear right by that hole.
107.075 -> What he can do is take
this little handy device
110.859 -> that we're all so familiar with,
112.749 -> that's called a stethoscope,
114.627 -> and this end, it's going in his ears.
116.915 -> Then, you have this tube,
118.355 -> and then, you have this chest piece,
121.338 -> and where you can listen
to the sounds of the heart.
125.144 -> Depending on the type of
non-cyanotic heart disease
128.876 -> that individual might have,
130.668 -> he'll be able to hear the squirting or
133.577 -> some type of a characteristic sound that's
137.262 -> the result of that defect.
139.36 -> This process, I'll give
you a fancy name for it,
142.689 -> it called auscultation.
145.794 -> All right, so, that is
when the doctor comes with
148.231 -> the stethoscope and since
this is a congenital defect,
151.453 -> when the baby is just born,
153.142 -> he listens to the sound of the heart,
155.014 -> and say, "Hey. I'm
hearing something that's
157.748 -> it's not exactly what
I would like to hear."
159.998 -> So, that is one way, by
listening to the heart.
163.668 -> Then, you can see the heart.
165.495 -> How do you see the heart?
166.567 -> Well, by taking a picture.
167.975 -> Unfortunately, you can't
just take a regular camera.
171.72 -> You need a more expensive machine,
174.631 -> and that expensive machine
is going to allow you
178.377 -> to be able to visualize the chest area,
182.927 -> and with that, it's just
like we're taking a picture.
186.628 -> It's just a little different.
188.115 -> It's not going to have
all the nice fancy colors,
191.306 -> and you'll be able to see the heart.
193.963 -> All right, so, this is my heart.
196.336 -> This is called a chest x-ray.
200.661 -> All right. You going x-ray machine.
203.538 -> You put the baby in the x-ray machine.
205.159 -> You take a picture, and you look to see,
207.317 -> all right, is there some
type of a structural defect
209.896 -> that's not suppose to be there?
211.565 -> That's one way to visualize the heart.
214.828 -> There's a second way to visualize
the heart that's even better.
218.174 -> Yeah, you can take a picture,
219.498 -> or you can take a video. Right?
222.56 -> With a fetal or postnatal ...
229.218 -> so, fetal is while the fetus is
still inside the mother's womb,
235.64 -> and postnatal, once that baby is born,
238.74 -> you take an echocardiogram.
242.696 -> So, echo ... ooh, that doesn't look right.
245.11 -> Echocardiogram.
249.539 -> What that does is you're
using sound waves,
252.527 -> and you're projecting it onto a screen,
254.97 -> so, that you can see the heart.
257.013 -> You see the heart as it's beating.
258.743 -> You see it contracting.
You see the valves closing.
261.48 -> You can also see in real time if there are
266.433 -> defects that should not be there.
268.393 -> So, that's number two.
269.589 -> We can visualize the heart by either using
272.532 -> a chest x-ray or a fetal or
postnatal echocardiogram.
278.203 -> There are some other
issues that we might notice
281.419 -> with non-cyanotic heart disease.
283.887 -> We said that blood is
going from the left side
286.191 -> to the right side, and
if you have more and more
289.271 -> blood going to the right side where it's
292.272 -> ultimately going to your lungs,
296.198 -> so, you have more gong to your lungs
298.417 -> some coming back but not
going as much to the body,
301.686 -> eventually, you're going to get buildup
303.874 -> in pressure in your lungs.
308.14 -> If you get a buildup in
pressure in your lungs,
310.525 -> that can feed back to the right side
313.971 -> causing buildup in pressure over here too.
319.269 -> If we have that buildup
in pressure over here,
321.351 -> the ventricle has to do much more work.
323.936 -> Now, if you go to the gym,
and you're exercising,
326.493 -> and you're doing a lot of work,
328.026 -> what's going to happen to your muscles?
329.37 -> Well, their going to get larger.
330.634 -> Their going to get significantly stronger.
332.556 -> That's going to start to happen on
335.591 -> the right side where you
have a larger heart muscle.
340.566 -> If you have larger heart muscle,
343.449 -> you will notice this when a doctor
346.487 -> comes and does an
349.003 -> electrocardiogram.
353.424 -> So, we take an electrocardiogram.
355.891 -> Cardiogram where we are looking at the
359.362 -> electrical signals throughout the heart.
362.608 -> With that, I'm going
to just sketch one out.
365.435 -> Right now we have our P wave,
367.981 -> and then, our QRS complex,
372.002 -> and then, we have our T wave.
375.858 -> If I look at that, so, this P wave,
379.127 -> our QRS complex, and
then, we have our T wave.
383.844 -> The P wave gives me the
electrical activity of the atria.
390.506 -> The QRS complex is
given you the electrical
393.462 -> activity of the ventricles. All right.
398.381 -> I'm not going to go into all the details.
399.856 -> I'm just going to kind of make it
401.331 -> just that simple for now.
402.989 -> If you have enlargement of the ventricles,
406.533 -> or the right ventricle,
408.095 -> what's that going to do to the signal?
409.652 -> Do you expect to see the same signal,
411.662 -> a larger signal, a smaller signal?
414.065 -> Well, if you have a bigger muscle,
415.705 -> I would expect to see a significantly
419.011 -> larger signal here with the ventricles.
424.204 -> If that feeds back to your atria,
426.708 -> and you have a larger right atrium,
429.701 -> well, you might see this being a larger,
431.93 -> a little broader, a little wider.
435.216 -> There are characteristics
features that you can
437.867 -> see in the electrocardiogram,
440.339 -> the ECG or EKG,
444.979 -> depending on where you are in the world.
447.612 -> That can give you an indication
449.835 -> as to whether there is some type of a
453.321 -> dysfunction in the
heart, as a result of the
456.49 -> load that's placed on the right ventricle,
460.58 -> and the right atrium, and
enlargement of those structures.
464.321 -> So, you can hear it. You can see it.
466.781 -> There are some functional
things that you can
469.736 -> notice in the electrocardiogram to help
473.184 -> diagnose a non-cyanotic heart defect.
Source: https://www.youtube.com/watch?v=tOUys6vlTvE