Cardiac Flashcards
Coronary Artery Disease (CAD)
- Cholesterol starts depositing into bits of damaged tissue creating a fatty bulge (plaque)
- Build up of plaque on the arteries that supply blood to the heart called coronary arteries
-Platelets cause plaque instability
-Platelets form a Thrombosis (clot) leading to further or total occlusion of the artery
-Obstructed coronary arteries = limited blood flow to tissues = cardiac cell death
Heart Failure
-Occurs when the Heart can’t meet the demands of the body
-Systolic HF: heart muscles aren’t pumping enough
-Diastolic HF: heart not filling with enough blood
-Impaired pump function = impaired circulation = impaored gas exchange = tissue and cell death
Cardiovascular Disease (CVD)
General term for conditions affecting the heart and blood vessels
Angina
-Symptom of CAD
-Inadequate blood supply to the heart
-Causes squeezing tight pain in shoulders, arm, neck, jaw and chest
Stable Angina
-Okay at rest
-Same pattern of onset
-Provoked by exacerbation
-Relieved by GTN
-Pain 10-15mins
-Not enough blood can get past the plaque, need to decrease exertion (work)
Unstable Angina
-Plaque can rupture and burst
-Exposes plaque material to blood
-Plaque is Thrombogenic, causing blood clots to form on the ruptured plaque
-Occurs at rest
-GTN doesn’t relieve
-SOB, fatigue, indigestion
-Cardiac enzymes not usually elevated
Acute Coronary Syndrome (ACS)
-Caused by prolonged ischemia (decreased O2 supply) to heart
-Associated with sudden plaque rupture
-Can lead to Myrocardial infarction or Unstable angina
Myocardial Infarction
-Heart attack
-Occurs due to sustained ischemia causing irreversible myocardial cell death
-Causes squeezing tight pain in shoulders, arms, neck, jaw, and chest
-Complications: arrhythmias, HF, Cardiogenic shock
-Can either be a STEMI or an NSTEMI
Cardiac Arrest
-Occurs when the heart stops pumping blood to the body
-Normal breathing stops and consciousness is lost
-CPR, defibrillator
-There are three types: ventricular tachycardia, ventricular fibrillation, pulseless electrical activity
Arythmia
Irregular heartbeat is a problem with the rate or rhythm of the heart
Can be too fast or too slow
Cardiogenic Shock
-Reduced stroke volume and cardiac output result in decreased cellular supply
-Hearts inability to pump blood
-Common causes: MI, arrhythmias, cardiomyopathy
Ventricular Tachycardia
-lower chambers of the heart have an irregular/rapid heartbeat
Ventricular Fibrillation
-An arrhythmia in the bottom chambers (ventricles of the heart)
-Can cause low BP or LOC
-Requires immediate CPR and defibrillation
Pulseless Electrical Activity (PEA)
-Condition where your heart stops because the electrical activity in your heart is too weak to make your heartbeat
-Cannot shock, must use epinephrine
Atrial Fibrilation
An irregular and often rapid heartbeat
Stroke Volume
-Amount of blood pumped out of the left ventricle during systolic cardiac contraction
Cardiomyopathy
disease of heart muscle making it hard for the heart to pump blood
NSTEMI -Non-ST wave elevated myocardial infarction
-Elevated cardiac enzyme
-Less severe than a STEMI
-Caused by a block in a minor artery or a partial obstruction in a major artery.
STEMI - ST wave elevated myocardial infarction
-Elevated cardiac enzyme
-Occurs when a ruptured plaque blocks a major artery completely
Atherosclerosis
Thickening or hardening of arteries caused by a build-up of plaque.
Depolarisation
-Atria contracts
-Ejection of blood
-QSR wave
-SA node shoots: atria fibers depolarise
-AV node shoots: ventricle fibers depolarise
Repolarisation
-Relaxation
-Filling
-T-wave
Cardiac Output
Blood pumped out of each ventricle per minute (ml/min)
CAD risks
-smoking
-obesity
-lifestyle
-high cholesterol
-family history
-diabetes
-kidney disease
-hypertension
Arrhythmia & Dysrhythmia causes
-age
-acute MI
-cardiac disease
-hypoxemia
-hypercapnia
-drugs/toxicity
-A/B imbalance
-electrolyte imbalance
Ischaemia
lack of O2 to tissues
Infarction
Total occlusion of blood vessel due to clot or narrowing causing tissue death
ACS presentations
-pale
-clammy
-collapse, sweating, pallor
-pulmonary oedema
-N&V
-bradycardia, tachycardia
-hypotensive
MI assessments
-previous ECG
-links between CAD, ACS, MI
-complaint? pain?
-Tachy/Brady
-Hypo/Hypertension
-prolonged cap refill
-Decreased urine output <1ml/kg/hr
-Altered perfusion
MI Interventions
-ECG
-Test 4 troponin due to cardiac injury
-administer O2
-Labs: lipid profile
-CXR
-GTN
-Asprin
-elevated bed head for dyspnoea
-PCI (percutaneous coronary interventions)
Asprin
-Anti-platelet
-Administered as soon as ACS is suspected
PCI - Percutaneous Coronary Interventions
-non-surgical procedure
-involves opening narrow/blocked sections of arteries
-inserted in the femoral or brachial artery, opens balloon, compresses atherosclerosis plaque, dilates artery, returns blood flow.
-1st treatment for MI
CABG - Coronary Artery Bypass Graft
- A surgical procedure to divert blood around narrow/blocked parts of the arteries
-For: failed medical management, difficult PCI access, failed PCI
Thrombolysis
-STEMI needs immediate reperfusion
-stop the infarction process by dissolving thrombosis and reperfusion myocardium
-if no PCI is available in a timely manner
-decreases mortality if reperfusion is within 6 hours
-rapid and does not require cardiac catheterisation
Cardiac catheterisation
tube guided through a blood vessel to the heart to diagnose/treat clogged arteries
Pulmonary Oedema (Caused by heart failure) interventions
-CXR
-monitoring
-treat underlying cause
-positioning
-O2 therapy
-fluid restriction/ daily weights
Cardiac Arrest Medications
-adrenaline
-amiadarone
-atropine
-magnesium sulfate
-calcium gluconate
-glycerole trinitrate
-asprin
Thromboembolism
a circulating blood clot that gets stuck and causes an obstruction
