Cardiac & Chest Flashcards
Pulmonary causes that cause chest discomfort
-Pulmonary embolism
-Pneumothorax
-Pleurisy
-Respiratory infections
GI causes that cause chest discomfort
-Esophageal rupture
-Dyspepsia
-Cholecystitis
-Gastroesophageal reflux disease
-Hiatal hernia
-Pancreatitis
-Peptic ulcer disease
-Sharp CP that increases w/ deep breathing/coughing
-Dizziness, syncope, ALOC
-Decreased systolic BP/Narrow pulse pressure
-JVD
-Faint & muffled heart sounds
-Nausea/Vomiting
-Pale, Cool, & Clammy
-Decreased Urine Output
-Palpitations/Tachycardia
-SOB
-Peripheral Edema
-Fatigue
EKG:
- Low QRS voltage
- Electrical Alternants
- Tachycardia
HX:
-Infections
-Cancer
-Autoimmune Disorders (Lupus, Rheumatoid Arthritis, Sjögren’s syndrome)
-Hypothyroidism
-Trauma/Surgery
-Radiation
-MI’s, Heart Failure, Heart Valve Issues
-Chronic Kidney disease, Kidney Failure or Liver Cirrhosis
Pericardial Effusion/Cardiac Tamponade
-Sharp/Stabbing Chest Pain
-Back, neck or left shoulder Pain
-Coughing Fits
-Fatigue/weakness/malaise
-Low-grade fever
-Hypotension
-Anxiety
-Orthopnea
-Palpitations
-Edema
EKG:
- Widespread concave ST elevation
- PR depression throughout most of the Limb leads (I,II,III, aVL & aVF) & precordial leads (V2-6)
- Reciprocal ST depression & PR elevation in lead aVR (& maybe V1)
- Sinus Tachycardia
HX:
-Infections
-Autoimmune disorders (lupus, rheumatoid arthritis and scleroderma)
-Trauma/Surgery
-MI
-Radiation
-Kidney Failure
Pericarditis
A swelling and irritation of the thin saclike membrane surrounding the heart (pericardium)
-Aching joints and muscles
-Oslet Nodes (Painful lesion on pads of fingers & toes)
-Janeway Lesions (non-painful lesions on palms & soles)
-Splinter Hemorrhages
-Chest pain when you breathe
-Paleness/Anemia
-Fever/Chills/Night sweats
-Fatigue
-Shortness of breath
-Edema
HX:
-Infection (Strep, Staph)
-IV Drug User
-Pacemaker
-Hypertrophic Cardiomyopathy
-Valvular or Congenital Diseases
-Autoimmune Disorders
Endocarditis
An infection of the heart’s inner lining, usually involving the heart valves
-Chest pain
Flu-like symptoms (headache, body aches, joint pain, fever or sore throat)
-Fatigue
-Edema
-Tachycardia or arrhythmia
-Shortness of breath, at rest or during activity
-Light-headedness or feeling like you might faint
-Decreased urine output
EKG:
- Sinus Tach w/ non specific ST segment & T wave changes
HX:
-Heart Meds
-Psych/Seizure Meds
-Infections or Viruses
-Autoimmune Disorders
Myocarditis
Inflammation of the middle layer of the heart wall
-Pain in extremity (severe & acute onset)
-Lowered skin temp distal to the occlusion
-Changes in CMS
-Diminished or absent pulse distal to the injury
-Pallor
-Slow cap refill
-Sometimes shock
Acute Arterial Occlusion
-Awakening at night w/ SOB
-SOB during exercise/Orthopnea
-Chronic coughing or wheezing
-Chest pain
-Rapid or irregular heartbeat
-Diaphoresis
-ALOC
-Edema/Weight-gain
-Lack of appetite and nausea
EKG:
- Large R waves on II, III, aVF, V1-3
- ST elevation in V1-3
- ST depression & T wave inversion I, aVL, & V5-6
Left Ventricular Failure
-Awakening at night w/ SOB
-SOB during exercise/Orthopnea
-JVD
-Increased urge to urinate
-Difficulty concentrating
-Coughing/Wheezing
-Dizziness/Fatigue
-Edema/Weight-gain
-Lack of appetite/Nausea
Right ventricular failure
-Joint Pain
-Shortness of breath (especially with activity or when lying down)
-Cough
-Chest pain & Palpitations
-Edema/weight-gain
HX:
-Strep
Rheumatic Heart Disease
Untreated Strep > Rheumatic fever > heart valve inflammation > scarring = narrowing or leakage of valves
-Chest Pain
-Palpitations/Tachycardia
-Crepitus/Abnormal Chest Wall Movement
-SOB/Tachypnea/Shallow Breathing
-Dizziness, Fatigue, Syncope, ALOC
-Decreased systolic BP/Narrow pulse pressure
-JVD
-Nausea/Vomiting
-Ventricular Rhythms/STEMI/RBBB
HX:
-Trauma
Myocardial Contusion
-Sharp CP that increases w/ deep breathing/coughing
-Crepitus/Abnormal Chest Wall Movement
-SOB/Tachypnea/Shallow Breathing
-Dizziness, Fatigue, Syncope, ALOC
-Palpitations/Tachycardia
-Decreased systolic BP/Narrow pulse pressure
-JVD
-Nausea/Vomiting
-Peripheral Edema
-Faint & muffled heart sounds
-Shock
HX:
-Trauma
Myocardial Rupture
LVAD Trouble shooting
ALOC =
Determine if the patient has adequate perfusion
If they do, assess for and treat other non-LVAD causes of ALOC, such as:
- Hypoxia
- Hypoglycemia
- OD
- Stroke
If the patient does not have adequate perfusion, determine if the LVAD is functioning =
Listen for the device motor humming or alarms being emitted from the device
If the LVAD is not functioning =
Ensure that the driveline and power source are connected
If the device is functioning =
Assess the patient’s mean arterial pressure (MAP) and end-tidal carbon dioxide (ETCO2)
If the patient’s MAP is greater than 60 mm Hg and/or the ETCO2 is greater than 20 mm Hg =
Do not perform chest compressions
If the MAP and/or ETCO2 are below these values (indicating poor end-organ perfusion) =
Begin chest compressions
When caring for an LVAD patient, it is important to contact the patient’s VAD coordinator early and to transport the patient to the facility where the VAD coordinator is located
