Cardiac Emergencies Flashcards
ACS
syndromes affecting the heart as a result of plaque rupture in the coronary arteries
Angina Pectoris
imbalance between myocardial O2 supply and demand
Accumulation of lactic acid and CO2 in ischaemic tissues of myocardium - metabolites irritate nerve endings and produce pain
Stable Angina
usually precipitated by physical exertion or emotional stress
typically lasts 1-5 mins
relieved by GTN and or O2
attacks are usually similar in nature and relieved by same therapy
Unstable Angina
pattern that has changed in onset, frequency, intensity, duration or quality
may occur during exercise or at rest
pain lasts greater than 10 mins and is less promptly relieved
indicitive of changes in degree of oclusion of coronary arteries
Myocardial INfarction
total or near occlusion of blood flowing through a coronary artery
Ischaemia, injury and necrosis of myocardium distal to occlusion
Often associated with atherosclerotic heart disease
Size of MI determined by:
metabolic needs of tissue supplied by occluded vessel
collateral circulation
time until flow is re-established
Nitrates in treating ACS
GTN has haemodynamic effecs such as dilation of venous capacitance vessels, dilation of coronary arteries and to a minor extent, peripheral arteries
Morphine in treating ACS
calming effect
a dilator of venous capacitance vessels
COngestive Heart Failure
develops when plasma volume increases and fluid accumulates in the lungs, abdo aorgans and peripheral tissues
LVF
left ventricle fails to function as an effective forward pump
causes back pressure of blood intu pulmonary circulation
causes of LVF
ischaemic heart disease
valvular disorders
hypertensive heart disease
LVF and APO symptoms
resp distress apprehension, agitation, confusion cyanosis diaphrosesis adventitious lung sounds jugular vein distension abnormal VSS
RVF
R ventricles fail as a forward pump causing back pressure of blood into systemic venous circulation
causes of RVF
chronic hypertension
pulmonary embolism
valvular heart disease
RV infarction
Signs and symptoms of RVF
tachycardia
venous congestion - venous distension and peripheral oedema
fluid accumulation in serous cavities
Cardiogenic shock
most extreme form of pump failure
LF function is compromised and heart cannot meet metabolic needs of body
pericardial effusion
when blood or fluid escapes into the pericardial space
can be: transudative - congestive heart failure, exudative - tuberculosis, haemorrhagic - trauma, malignant - cancer
symptoms of pericardial effusion with tamponade
chest pain
duspnoea
hypotension
distant heart sounds
Water bottle heart
a radiographic sign of pericardial effusion
Ewart’s sign
dullness to percussion over the left subscapular area due to compression of left lung base
Cardiac tamponade
increased fluid in pericardial space
impairs diastolic filling of heart
ventricular filing is mechanically limited and SV decreases
Pericarditis
inflammation of pericardium
Pericarditis results from
trauma infection MI malignant neoplastic disease ureaemia idiopathic causes
Aortic Dissection
a tear in the intimal layer of a vessel wall resulting in separation into 2 layers
Aortic Aneurysm
dilation of all 3 layerss of the aorta
Acute Arterial Occlusion
blockage of arterial flow caused by: trauma, embolus, thrombus
Severity of Acute Arterial Occlusion depends on
site of occlusion
collateral circulation
DVt
occlusion of deep veins more commonly in lower extremities
Angiography
imaging technique to visualise coronary arteries
