Cardiac Emergencies Flashcards
What is a cardiac emergency?
A sudden, life-threatening situation where normal heart function is disrupted, requiring immediate medical attention.
What are common examples of cardiac emergencies?
Myocardial infarction, cardiac arrest, unstable angina, pulmonary embolism, aortic dissection, cardiac tamponade, sudden cardiac death, and lethal arrhythmias.
What is the leading cause of cardiac emergencies?
Coronary artery disease and arrhythmias.
What are the modifiable risk factors for cardiac emergencies?
High blood pressure, smoking, physical inactivity, obesity, diabetes, and an unhealthy diet.
What are the non-modifiable risk factors for cardiac emergencies?
Age, gender, and genetic predisposition.
What are the key components of managing a cardiac emergency?
Early recognition, CPR, defibrillation, and case-specific treatments.
What is the first step in managing a suspected cardiac arrest?
Check for consciousness, pulse, and breathing; call emergency services if absent.
What is the role of an Automated External Defibrillator (AED)?
To analyze heart rhythm and deliver an electric shock if necessary to restart the heart.
What is the first-line treatment for ventricular fibrillation (VF)?
Immediate defibrillation followed by CPR.
What is the purpose of coronary angioplasty in cardiac emergencies?
To open blocked coronary arteries and restore blood flow.
What is the initial response to a cardiac arrest?
Call emergency services, perform CPR, and use an AED if available.
What are the symptoms of a heart attack (myocardial infarction)?
Chest pain, shortness of breath, nausea, sweating, and pain radiating to the arm or jaw.
What is the role of aspirin in a heart attack?
It reduces clot formation and improves blood flow to the heart.
How is cardiac tamponade treated?
Emergency pericardiocentesis to drain excess fluid from the pericardium.
What is the hallmark sign of aortic dissection?
Sudden, severe chest pain that radiates to the back.
What is the recommended compression-to-breath ratio in CPR?
30 compressions to 2 breaths.
How deep should chest compressions be during CPR?
At least 4-5 cm (1.5-2 inches) deep.
What is the target compression rate for CPR?
100-120 compressions per minute.
What is the primary function of an implantable cardioverter-defibrillator (ICD)?
To detect and correct life-threatening arrhythmias automatically.
What is the most common cause of sudden cardiac death?
Ventricular fibrillation.
What is the definitive treatment for complete heart block?
Pacemaker implantation.
What is the first-line drug for bradyarrhythmias?
Atropine.
What is the first-line treatment for pulseless electrical activity (PEA)?
High-quality CPR and identifying the underlying cause (H’s and T’s).
What are the ‘H’s and ‘T’s of cardiac arrest?
Hypoxia, Hypovolemia, Hydrogen ion (acidosis), Hyper-/Hypokalemia, Hypothermia, Toxins, Tamponade, Tension pneumothorax, Thrombosis (coronary or pulmonary).
What are the indications for advanced life support (ALS)?
Persistent cardiac arrest despite initial CPR and defibrillation.
What is the first-line antiarrhythmic for refractory ventricular fibrillation?
Amiodarone.
What is the role of epinephrine in cardiac arrest?
Increases coronary perfusion and enhances cardiac output.
What is the recommended dose of epinephrine during cardiac arrest?
1 mg IV every 3-5 minutes.
What is the best initial test for diagnosing myocardial infarction?
ECG.
What are the ECG findings in ST-elevation myocardial infarction (STEMI)?
ST-segment elevation in two or more contiguous leads.
What cardiac marker is most specific for myocardial infarction?
Troponin.
What is the first-line treatment for unstable angina?
Aspirin, nitroglycerin, beta-blockers, and heparin.
What is the recommended time window for percutaneous coronary intervention (PCI) in STEMI?
Within 90 minutes of first medical contact.
What is the preferred thrombolytic agent for STEMI if PCI is not available?
Alteplase (tPA).
What is the major contraindication for thrombolytic therapy?
Active bleeding, recent stroke, severe hypertension, or intracranial hemorrhage.
What is the treatment for bradycardia with hemodynamic instability?
Atropine, followed by transcutaneous pacing if needed.
What is the role of beta-blockers in acute coronary syndrome?
Reduces myocardial oxygen demand and prevents arrhythmias.
What are the indications for coronary artery bypass grafting (CABG)?
Severe multi-vessel coronary artery disease or failed PCI.
What is the first-line treatment for pulmonary embolism with hemodynamic instability?
Thrombolysis or surgical embolectomy.
What is the classic ECG finding in pulmonary embolism?
S1Q3T3 pattern (deep S in lead I, Q wave in lead III, inverted T in lead III).
What is the role of anticoagulation in pulmonary embolism?
Prevents clot propagation and recurrence.
What is the most effective way to prevent cardiac emergencies?
Lifestyle modification: smoking cessation, diet, exercise, and blood pressure control.
What is the role of implantable defibrillators in post-cardiac arrest patients?
Prevents recurrent sudden cardiac death in high-risk patients.
What are the three types of cardiac arrest rhythms?
Ventricular fibrillation (VF), pulseless ventricular tachycardia (pVT), and asystole/PEA.
What is the immediate treatment for asystole?
High-quality CPR and epinephrine; defibrillation is not indicated.
What is the survival rate for out-of-hospital cardiac arrest with early defibrillation?
Increases to over 50% if performed within minutes.
What are the key predictors of good outcomes in cardiac emergencies?
Early bystander CPR, early defibrillation, and advanced life support.
What is the target post-resuscitation oxygen saturation?
94-98% to avoid hyperoxia injury.
What is the role of targeted temperature management (TTM) after cardiac arrest?
Reduces neurological damage in comatose survivors of cardiac arrest.
What lifestyle modifications reduce the risk of recurrent cardiac emergencies?
Healthy diet, regular exercise, smoking cessation, and blood pressure control.
What is the first-line medication for hypertensive emergency?
IV nitroprusside or labetalol, depending on the cause.
