346 Chapter 14
Case Study^
Enrico Shavez, an 8^0 - year-old man, is admitted to the emergency room with -severe
pain in his chest and shoulder, which is radiating down his left arm. Enrico appears
extremely apprehensive. He tells his health care provider that he has experi-enced
similar episodes of chest pain in the past, which were apparently triggered by stress.
Based on his symptoms, the care provider tells Enrico that he is experiencing an attack
of angina pectoris. She treats his condition, and then instructs Enrico to see his primary
health care provider as soon as possible. Meanwhile, Enrico is advised to^
avoid stressful situations and take a small dose of aspirin daily.
Questions
- What underlying heart condition causes the chest pain associated with angina
pectoris?
2.^ What life-threatening complication could Enrico develop?^
3.^ What diet should Enrico follow to reduce his risk of further attacks?^
4.^ What type of exercise program is safest for older adults with a heart condition?^ - What surgery might Enrico need to undergo to treat his heart condition?
LABORATORY
EXERCISE:
The Cardiovascular System
Materials needed: A dissecting kit, a preserved
sheep heart, and a dissecting pan- Your instructor will supply you with a sheep
heart. It is very close in size to a human heart.
Examine the external anatomy of the heart. If
the pericardial sac is still present, remove it.
Otherwise notice the auricles, the appendages
of the atria. Notice how irregu-lar and gray
they are. As you hold the heart in your hand,
notice that most of the heart is ventricles; in
fact, about three-quarters of what you are
holding are the ventricles.^ - Find the coronary sulcus. This is the exter-nal
horizontal groove that goes around the heart
and separates the atria from the ven-tricles
externally. Locate the anterior and posterior
interventricular sulci that sepa-rate the right
and left ventricles from one another
externally. Note the sulci have fat deposits in
them and blood vessels. - You will now cut the heart into two mirror
images to view the internal anatomy. First,
locate the two auricles. Now with your scal-
pel make a horizontal cut medially between
the two auricles across the top of the heart.
Continue cutting in a slicing motion down to
the apex of the ventricles. Now separate the
two halves. You will have cut the heart into
two half sections, each a mirror im-age of the
other. Refer to Figure- 14-4 in your text. - The easiest way to identify the correct
chambers you are viewing is to note which
ventricle has the thickest outermost wall.
Remember, the thick interventricular sep-tum
is shared by both ventricles. Locate the
outermost walls. The thickest outermost wall
will belong to the left ventricle. Once you
have identified this, chamber recogni-tion
should proceed easily. Above the left