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EMT > Ch 16 Cardiovascular Emergencies > Flashcards

Ch 16 Cardiovascular Emergencies Flashcards

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1
Q

Acute coronary syndrome

A

Symptoms caused by myocardial ischemia; includes angina and myocardial infarction

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2
Q

AMI

A

Acute Myocardial Infarction a.k.a. heart attack; death of the heart muscle following obstruction of blood flow to it; acute in this contest means new/happening now

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3
Q

Angina pectoris

A

Transient (short lived) chest discomfort caused by partial or temporary blockage of blood flow to the heart; angina

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4
Q

Aorta

A

Main artery, which receives blood from the left ventricle and delivers it all other arteries that carry blood to the body

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5
Q

Aortic aneurysm

A

a weakness in the wall of the aorta that makes it susceptible to rupture

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6
Q

Aortic valve

A

one-way valve that lies between the left ventricle and the aorta and keeps blood from flowing back into the left ventricle after the left ventricle ejects blood into the aorta; one of four heart valves

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7
Q

Artifact

A

A tracing on an EKG as a result of interference, such as patient movement, rather than electrical activity

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8
Q

Asystole

A

The complete absence of all heart electrical activity

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9
Q

Atherosclerosis

A

A disorder in which the cholesterol and calcium build up inside the walls if blood vessels, eventually leading to partial or complete blockage of blood flow

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10
Q

Atrium

A

One of two (R and L) upper chambers of the heart: incoming
Right atrium: receives blood from the Vena Cava and delivers to the right ventricle
Left atrium: receives blood from pulmonary veins and delivers to Left Ventricle

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11
Q

Automaticity

A

The ability of the cardiac muscle cells to contract without stimulation from the nervous system; not found in any other cells

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12
Q

Autonomic nervous system

A

Controls involuntary activities - HR, BP

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13
Q

Bradycardia

A

Slow heart rate, < 60 bpm

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14
Q

Cardiac arrest

A

When the heart fails to generate effective and detectable blood flow; pulses are not palpable in cardiac arrest, even if muscular electrical activity continues in the heart

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15
Q

Cardiac output

A

A measure of volume of blood circulated by the heart in 1 minute = stroke volume X the heart rate

Increased to meet increased metabolic rates

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16
Q

Cardiogenic shock

A

A state where not enough oxygen is delivered to the tissues of the body, caused by low output of blood from the heart. It can be a severe complication of a large MI or other conditions

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17
Q

CHF

A

Congestive heart failure
Disorder where the heart loses part of its ability to effectively pump blood, usually as a result of damage to the heart muscle and usually resulting in a backup of fluid into the lungs

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18
Q

Coronary arteries

A

Blood vessels that carry blood and nutrients to the heart

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19
Q

Defibrillate

A

to shock a fibrillating (chaotically beating) heart with specialized electric current in an attempt to restore a normal, rhythmic beat

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20
Q

Dependent edema

A

Swelling in the part of the body closes to the ground, caused by collection of fluid in the tissues, a possible sign of CHF

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21
Q

Dilation

A

Widening of a tubular structure such as a coronary artery

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22
Q

Dissecting aneurysm

A

When the inner layers of an artery, such as the aorta, become separated, allowing blood (at high pressure) to flow between the layers

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23
Q

Dysrhythmia

A

irregular or abnormal heart rhythm

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24
Q

Hypertensive emergency

A

An emergency situation created by excessively high blood pressure, which can lead to serious complications such as stroke or aneurysm

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25
Q

Infarction

A

Death of a body tissue, usually caused by interruption of blood supply

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26
Q

Ischemia

A

Lack of oxygen that deprives tissues of necessary nutrient, resulting from partial or complete blockage of blood flow; potentially reversible because permanent injury may not have occurred yet

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27
Q

Lumen

A

The inside diameter of an artery or other hollow structure

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28
Q

Myocardium

A

The heart muscle

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29
Q

Occlusion

A

A blockage, usually of a tubular structure such as a blood vessel

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30
Q

Parasympathetic nervous system

A

Controls vegetative functions such as digestion and relaxation

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31
Q

Perfusion

A

Flow of blood through body/tissues

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32
Q

ROSC

A

Return of Spontaneous Circulation

The return of a pulse and effective blood flow to the body in a patient who previously was in cardia arrest

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33
Q

Stroke volume

A

volume of blood ejected with each ventricular contraction

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34
Q

Sympathetic nervous system

A

Controls active functions such as responding to fear (fight or flight)

35
Q

Tachycardia

A

Rapid heart rate, > 100 bpm

36
Q

Thromboembolism

A

A blood clot formed within a blood vessel and is floating within the bloodstream

37
Q

Ventricle

A

One of two (R and L) lower chambers of the heart: Outgoing
Left ventricle: receives blood from left atrium and delivers blood to the aorta;
Right ventricle: receives blood from the right atrium and pumps it into the pulmonary artery

38
Q

Ventricular fibrillation

A

V-Fib

Disorganized, ineffective quivering of the ventricles, resulting in no blood flow and a state of cardiac arrest

39
Q

Ventricular tachycardia

A

V-Tach
Rapid heart rhythm in which the electrical impulse begins in the ventricle instead of the atrium, which may result in inadequate blood flow and eventually deteriorate into cardiac arrest

40
Q

The leading killer of Americans since the 1900s

A

Heart disease

41
Q

Explain the flow of blood through the Heart/Lungs

A

Right atrium receives deoxygenated blood from the vena cava > to the right ventricle > pulmonary artery > to the lungs and receives fresh oxygen > pulmonary vein > left atrium receives oxygenated blood > left ventricle > to the rest of the body through the aorta

42
Q

Normal electrical impulses begin at the ____

A

Sinus node; sinoatrial node (SA)

The impulses travel across both atria, stimulating them to contract; controlled by autonomic nervous system

43
Q

Between the atria and the ventricles, electrical impulses cross a bridge of special electrical tissue called the ____

A 
Atrioventricular node (AV)
The signal is slowed for about 1/10 to 2/10 of a second to allow blod time to pass from the atria to the ventricles
44
Q

Electrical impulses exit the AV node and ____

A

Spread through both ventricles via the bundle of His, the R and L bundle branches and the Purkinje fibers causing contraction

45
Q

Other myocardial cells will contract if ____

A

normal impulses begin at the SA node

46
Q

Other myocardial cells are capable of creating their of impulses and stimulating contraction of the heart, however ____

A

They are generated at a slower rate

47
Q

When does the myocardium require more oxygen?

A

During periods of stress of physical exertion

48
Q

Increased oxygen demand of the heart itself is supplied by ____

A

dilation of the coronary arteries, which increases blood flow

49
Q

Blood is supplied to the head and brain by

A

The right and left carotid arteries

50
Q

Blood is supplied to the upper extremities by

A

The right and left subclavian arteries (becomes brachial and divides into radial an ulnar in the arms)

51
Q

Blood is supplied to the groin, pelvis and legs by

A

The descending aorta, which divides into the right and left iliac arteries

52
Q

Blood is supplied to the lower extremities by

A

The right and left femoral arteries (divides into anterior and posterior tibial arteries and peroneal arteries )

53
Q

Capillaries

A

Connect arterioles to venules and are found in all parts of the body; allows for the exchange of nutrients and waste at a cellular level

54
Q

Venules

A

The smallest branches of veins

55
Q

Veins

A

oxygen-poor blood enters a system of veins; eventually come to the Vena Cavae

56
Q

Carries blood from the head and arms back to the right atrium

A

Superior Vena Cava

57
Q

Carries blood from the kidneys, abdomen and legs back to the right atrium

A

Inferior Vena Cava

58
Q

Brittle plaques may sometimes crack, exposing the inside of an atherosclerotic wall, which acts like ____

A

A torn blood vessel and activates the clotting system and the resulting clot will partially or completely block the lumen of the artery

59
Q

Major controllable risk factors for AMI

A 
Smoking
High blood pressure
Elevated cholesterol 
Elevated blood glucose levels
Lack of exercise 
Obesity
60
Q

Major uncontrollable risk factors for AMI

A 
Age (older)
Family history of atherosclerotic coronary artery disease
Race
Ethnicity 
Sex (men)
61
Q

Angina is most often the result of

A

Atherosclerotic coronary artery disease

Sometime the result of an arterial spasm

62
Q

Angina is commonly described as

A

Crushing, squeezing, “like somebody is standing on my chest”

63
Q

Angina is commonly felt

A

In the mid portion of the chest, under the sternum, but may radiate to the jaw, arms (frequently left), and mid-portion of the back or epigastrium (upper mid region of abdomen)

64
Q

Pain from angina typically lasts

A

3-8 minutes, rarely longer than 15 minutes

65
Q

Angina S/S typically subside with administration of

A

Supplemental oxygen and nitroglycerine, which decrease the need and increase supply of O2 to the heart

66
Q

Unstable angina

A

Characterized by pain or discomfort that occurs in response to progressively less exercise or fewer stimuli than originally required to produce it; can lead to AMI if left untreated

67
Q

Stable angina

A

Characterized by pain or discomfort that is relieved by things that normally relieve it, such as resting, nitro

68
Q

AMI is most likely to occur in the

A

Left ventricle

69
Q

S/S of AMI

A

Sudden onset of weakness, nausea, sweating w/o obvious cause
Chest pain, discomfort, pressure that is crushing or squeezing and does not change with breaths
Pain, discomfort or pressure in the lower jaw, arms, back, abdomen, neck
Irregular heartbeat, syncope
Shortness of breath, dyspnea
Nausea/vomiting
Pink frothy sputum (indicates possible pulmonary edema)
Sudden death

70
Q

In AMI, cells begin to die after ___

A

30 minutes after blood flow is cut off

71
Q

In AMI, after 2 hours without blood flow as many as ____ cells in the area can be dead

A

Half/50%

72
Q

In AMI, after 4-6 hours without blood flow, as many as ____ cells will be dead

A

90%

73
Q

Once dead, heart cells ____

A

Turn to scar tissue and become a burden to the beating heart, which is why rapid intervention is so critical

74
Q

Pain from AMI is different from Angina in three ways:

A

1) it may not be caused by exertion but can occur at any time, sometimes when sleeping or sitting
2) it does not resolve in a few minutes, rather it can last between 30min and several hours
3) it may or may not be relieved by rest or nitroglycerine

75
Q

Cardiac deinal

A

People may not seek medical attention because a fear of dying and do not want to face that possibility
Middle aged men are most likely to minimize symptoms

76
Q

Older people and women experiencing AMI may not ____

A

Experience any pain but have other common complaints associated with ischemia
“silent MI”

77
Q

AMI - general appearance

A

frightened, nausea/vomiting or cold sweats, pale or ashen skin, occasionally cyanosis

78
Q

AMI - pulse

A

generally pulse rate increases in response to fear/stress/pain, dysrhythmias are common so you may feel irregularity or slowing of the pulse

79
Q

Damage to the inferior area in an AMI often presents with ____ (pulse)

A

bradycardia

80
Q

AMI - blood pressure

A

May fall as a result of diminished cardiac output, most patients have normal or possibly elevated BP

81
Q

AMI - respirations

A

Usually normal unless patient has CHF, complaint of difficulty breathing is common
In cases of CHF, may become rapid and labored, with higher likelihood of cyanosis and frothy sputum

82
Q

AMI - mental status

A

Often experience confusion or agitation, overwhelming feeling of impending doom

83
Q

Approximately ____ of AMI patients do not reach the hospital alive

A

40%

EMT (25 decks)

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