Cardiac Emergencies

Question 1

ACS

Answer 1

syndromes affecting the heart as a result of plaque rupture in the coronary arteries

Question 2

Angina Pectoris

Answer 2

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

Question 3

Stable Angina

Answer 3

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

Question 4

Unstable Angina

Answer 4

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

Question 5

Myocardial INfarction

Answer 5

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

Question 6

Size of MI determined by:

Answer 6

metabolic needs of tissue supplied by occluded vessel
collateral circulation
time until flow is re-established

Question 7

Nitrates in treating ACS

Answer 7

GTN has haemodynamic effecs such as dilation of venous capacitance vessels, dilation of coronary arteries and to a minor extent, peripheral arteries

Question 8

Morphine in treating ACS

Answer 8

calming effect

a dilator of venous capacitance vessels

Question 9

COngestive Heart Failure

Answer 9

develops when plasma volume increases and fluid accumulates in the lungs, abdo aorgans and peripheral tissues

Question 10

LVF

Answer 10

left ventricle fails to function as an effective forward pump
causes back pressure of blood intu pulmonary circulation

Question 11

causes of LVF

Answer 11

ischaemic heart disease
valvular disorders
hypertensive heart disease

Question 12

LVF and APO symptoms

Answer 12

resp distress
apprehension, agitation, confusion
cyanosis
diaphrosesis 
adventitious lung sounds
jugular vein distension
abnormal VSS

Question 13

RVF

Answer 13

R ventricles fail as a forward pump causing back pressure of blood into systemic venous circulation

Question 14

causes of RVF

Answer 14

chronic hypertension
pulmonary embolism
valvular heart disease
RV infarction

Question 15

Signs and symptoms of RVF

Answer 15

tachycardia
venous congestion - venous distension and peripheral oedema
fluid accumulation in serous cavities

Question 16

Cardiogenic shock

Answer 16

most extreme form of pump failure

LF function is compromised and heart cannot meet metabolic needs of body

Question 17

pericardial effusion

Answer 17

when blood or fluid escapes into the pericardial space

can be: transudative - congestive heart failure, exudative - tuberculosis, haemorrhagic - trauma, malignant - cancer

Question 18

symptoms of pericardial effusion with tamponade

Answer 18

chest pain
duspnoea
hypotension
distant heart sounds

Question 19

Water bottle heart

Answer 19

a radiographic sign of pericardial effusion

Question 20

Ewart’s sign

Answer 20

dullness to percussion over the left subscapular area due to compression of left lung base

Question 21

Cardiac tamponade

Answer 21

increased fluid in pericardial space
impairs diastolic filling of heart
ventricular filing is mechanically limited and SV decreases

Question 22

Pericarditis

Answer 22

inflammation of pericardium

Question 23

Pericarditis results from

Answer 23

trauma
infection
MI
malignant neoplastic disease
ureaemia
idiopathic causes

Question 24

Aortic Dissection

Answer 24

a tear in the intimal layer of a vessel wall resulting in separation into 2 layers

Question 25

Aortic Aneurysm

Answer 25

dilation of all 3 layerss of the aorta

Question 26

Acute Arterial Occlusion

Answer 26

blockage of arterial flow caused by: trauma, embolus, thrombus

Question 27

Severity of Acute Arterial Occlusion depends on

Answer 27

site of occlusion

collateral circulation

Question 28

DVt

Answer 28

occlusion of deep veins more commonly in lower extremities

Question 29

Angiography

Answer 29

imaging technique to visualise coronary arteries