Cardiology Lecture 4 Flashcards
coronary artery disease
inability to deliver oxygenated blood because of plaque build up
goals of management of cardiac compromise
- increase oxygen supply, if needed
- decrease oxygen demand (decrease workload of heart)
- minimize and prevent and further damage
acute coronary syndrome
any condition causing sudden, reduced blood flow to the heart muscle
* stable angina
* unstable angina
* myocardial infarction
unmodifiable risk factors for actue coronary syndromes
- age
- sex
- ethnicity
- family history
- pregnancy
modifiable risk factors for actue coronary syndromes
- hypertension
- diet
- obesity
- smoking
- excessive alchol use
- stress
- high blood sugar
- physical inactivity
types of chest pain
- midsternal or substernal chest pain
- pain radiating from the chest to the scapula, neck, jaw or the left or right arm
- “heartburn” or “indigestion”
- non-traumatic left arm pain
- pressure, squeezing or crushing pain
angina pectoris
- “chest pain”
- inadequacy of oxygen to the heart muscle
- oxygen demand exceeds supply, causing anaerobic metabolism and lactic acid buildup
symptoms of stable angina
- temporary
- occurs upon exertion
- resolves with rest and or medication (aspirin, nitro)
symptoms of unstable angina
- constant
- does not resolve
- more likely to be a myocardial infarction
myocardial infarction
- heart attack
- sudden blockage of the coronary artery and prolonged ischemia
- results in death of myocardial tissue
signs and symptoms of myocardial infarction
- chest pain (pressure)
- radiating pain
- nausea and or vomiting
- dyaphoresis: excessive sweat
- dyspnea
- weakness
- hypotension
complications of myocardial infarction
- dysrhythmias (irregular heart rhythm)
- acute pulmonary edema and or heart failure
- cardiogenic shock
- cardic arrest: sudden death
- over 800, 00 MI, 179,000 of those are dead
cardiac chest pain treatment
- perform a thorough assessment
- oxygen, if shortness of breath
- treat for shock if present
- Aspirin, Nitroglycerin
- 12 lead EKG
- transport to a cardiac center
steps in definitive care
- STEMI receiving facility
- cardiac cath lab
- “clot-busting” medication
- angioplasty
congestive heart failure
- failure of the ventricles to keep up with the blood returning to the atriums
congestive heart failure
- blood backs up through the pulmonary veins
- fluid is forced out of the capillaries into the alveoli: pulmonary edema
risk factors of congestive heart failure
- lifetime of hypertension
- following a myocardial infarction
- valve disease
signs and symtptoms of right side heart failure
- peripheral edema
- swollen feet
- distended jugular veins
signs and symptoms of left sided heart failure
- pulmonary edema
- tripod position
- drowning
- cyanosis
- increased heart rate and respiratory rate
cardiogenic shock
- pump problem caused by damage to heart muscle, dysrhythmias
- drop in stroke volume causing poor prefusion
- blood flow backups
- pulmonary edema
complications of cardiogenic shock
- drop in stroke volume causing poor perfusion
- blood flow backsup
- pulmonary edema
acute aortic aneurysm
defect in wall of aorta leading to shearing and balloon effect which obstructs blood flow
risks of acute aortic aneurysm
- hypertensive male between ages 40 and 70 years
- connective tissue diseases
- blunt force trauma
signs and symptoms of acute aortic aneurysm
- unequal radial and femoral pulses
- unequal blood pressure
- pulsating mass if abdominal
- shock (hypoperfusion)
signs and symptoms of chronic hypertension (HTN)
- systolic blood pressure above 130 mmHg
- unless sudden significant increase, no significant symptoms
- significant risk factor for MI, CHF, aortic aneurysm, renal failure
signs and symptoms of emergency hypertension
- sudden increase in SBP above 180
- strong, bounding pulse
- ringing in the ears
- nausea and vomiting
- dizziness
- warm skin (dry or moist)
- nosebleed
- altered mental status
- “flash” pulmonary edema
indications for 12-lead EKG
- chest pain
- non-traumatic jaw, neck, upper back pain
- heart palpitations
- syncope or near syncope
- weakness
- pulmonary edema
- feeling of impending doom
obtaining a 12 lead EKG
- 12 views of the left ventricle
- changes in electrical activity
setting up a 12 lead EKG
- aerate the skin with an alcohol prep pad
- apply electrode
