CAD Flashcards
Coronary artery disease
Acute coronary syndrome - Contributing to the leading cause of death. Most infarcts occur at rest. Nitro has little effect on pain.
Signs and Symptoms
Cold Sweat and weakness, impending doom, Apprehension, Lightheadedness, syncope, dyspnea, cough, nausea and vomiting.
Physical exam
Dysrhythmia common, S4 very common, Wheezing, Pulmonary crackles, low grade fever during first 48 hours, Tachycardia has little effect
Work up
EKG changes however 30% of patients have no initial EKG changes. EKG changes might include Pete T waves, ST elevation or Q waves development. Mostly in 1 and aVL, or II, III, and aVF, or the V leads V3 and V4.
Cardiac enzymes elevations above normal within 4 to 6 hours and will remain high for several days three days for three weeks.
Echocardiogram for Wall motion abnormalities and ejection fraction
Leukocytosis 10,000 to 20,000 on the second day water and ice please
Monitor for heart blocks
1st degree AV block, PR interval >.20 seconds
Type 1 2nd degree AV bloc Thomas Stanley went outsecond degree AV block when he back or Mobitz type onegreater than point two0 seconds
