ch 17 Flashcards
What is the function of the heart
To pump blood throughout the body
What is the myocardium
The heart muscle responsible for contractions
What is the difference between arteries and veins
Arteries carry blood away from the heart and veins carry it back
What are the two major coronary arteries
Right and left coronary arteries
What is atherosclerosis
Buildup of plaque in blood vessels causing narrowing
What is acute coronary syndrome (ACS)
A group of symptoms from myocardial ischemia
What are two main types of ACS
Angina pectoris and myocardial infarction
What is angina pectoris
Chest pain from temporary lack of oxygen to the heart
What triggers angina
Exertion stress or heavy meals
How is angina relieved
Rest or nitroglycerin
What is a myocardial infarction (MI)
Death of heart muscle from lack of oxygen
How is MI pain different from angina
MI pain is longer-lasting not always relieved by rest or nitro
What are classic signs of MI
Chest pain/pressure nausea sweating dyspnea feeling of impending doom
What is a “silent MI
” An MI without obvious chest pain (often seen in elderly or diabetics)
What is congestive heart failure (CHF)
A condition where the heart can’t pump effectively
What are signs of left-sided CHF
Pulmonary edema crackles dyspnea orthopnea
What are signs of right-sided CHF
Peripheral edema JVD liver congestion
What is cardiogenic shock
Shock from the heart’s inability to pump blood
What are signs of cardiogenic shock
Low BP
What is hypertensive emergency
Systolic BP >180 with signs of organ damage (e.g. headache ALOC pulmonary edema)
What is a dissecting aortic aneurysm
Tear in the inner lining of the aorta causing severe chest/back pain
How is pain from aortic dissection described
Tearing or ripping often between shoulder blades
What is the dose of nitroglycerin for chest pain
0.3–0.4 mg sublingual repeated up to 3 times if allowed
What are contraindications for nitroglycerin
Systolic BP <100
What is the primary treatment for cardiac arrest
High-quality CPR and defibrillation
What is the chain of survival
Early access early CPR early defibrillation early advanced care post-arrest care
What should you do if you suspect ACS (Acute coronary Syndrome)
Administer oxygen if needed assist with nitro rapid transport
What rhythm is shockable with an AED
Ventricular fibrillation or pulseless ventricular tachycardia
When do you begin CPR
If patient is pulseless and apneic
What is the most common cause of a myocardial infarction
Atherosclerosis (plaque buildup) leading to a blockage in a coronary artery
What is the “widowmaker” heart attack
A blockage in the left anterior descending (LAD) artery
What does the term “time is muscle” mean
The faster the treatment for a myocardial infarction the less heart muscle damage occurs
What is pericarditis
Inflammation of the pericardium (the heart’s lining) that causes chest pain
What is the difference between stable and unstable angina
Stable angina occurs with activity and resolves with rest and unstable angina occurs at rest or with minimal exertion and is more severe
What is a common side effect of nitroglycerin
Headache and hypotension
What is the first thing you should do when you suspect a myocardial infarction
Ensure the patient is in a comfortable position and administer oxygen if needed
How do you recognize a patient with left-sided heart failure
Pulmonary edema dyspnea tachypnea and crackles upon auscultation
What is the treatment for a patient in cardiogenic shock
High-flow oxygen IV fluids (cautiously) and transport to a facility capable of advanced cardiac care
What is the “gallop” heart sound
An abnormal heart sound indicative of heart failure usually from fluid in the lungs
What is the significance of jugular vein distention (JVD)
It is a sign of right-sided heart failure (indicating fluid buildup)
What is the most effective treatment for a patient in severe
acute congestive heart failure (CHF)
What does “tachycardia” refer to
A heart rate greater than 100 beats per minute
What are signs of shock in the cardiovascular system
Low blood pressure weak and rapid pulse cool and clammy skin
What is the main difference between a STEMI and NSTEMI
STEMI shows a full-thickness injury of the heart muscle with ST-segment elevation on an ECG NSTEMI involves partial thickness injury with no ST-segment elevation
What is the treatment for a suspected dissecting aortic aneurysm
Rapid transport to a trauma center and supportive care with caution to avoid aggressive fluid resuscitation
What is the purpose of aspirin in the treatment of myocardial infarction
To reduce clot formation and prevent further damage to the heart muscle
How do you treat a patient with a hypertensive crisis
Lower the blood pressure slowly and carefully (using medications if necessary)
What is the primary concern with a hypertensive emergency
Risk of organ damage (kidneys heart brain) due to excessively high blood pressure
What is the goal of treatment for myocardial infarction
To restore oxygen to the heart muscle as quickly as possible
What is the best position for a patient experiencing a myocardial infarction
Comfortably sitting or semi-reclining allowing them to breathe easier
What should you assess when you suspect aortic dissection
Severe chest or back pain sudden onset ripping/tearing nature of pain
What is the recommended first aid for a patient with acute chest pain
Administer oxygen apply aspirin if no contraindications prepare for rapid transport
When should you administer oxygen in the case of chest pain
Whenever the patient shows signs of hypoxia or respiratory distress
What is a key intervention for treating heart failure
Reducing the workload on the heart with medications (diuretics nitroglycerin and CPAP)
How do you differentiate between chest pain from a GI issue vs a cardiac problem
GI pain is usually related to meals and can be relieved with antacids while cardiac pain may be triggered by exertion and accompanied by other symptoms like nausea and sweating
What is the role of an AED in the case of sudden cardiac arrest
To deliver a shock to restore normal rhythm in cases of ventricular fibrillation or pulseless ventricular tachycardia
What is the first thing you should do for a MI patient
Administer high-flow oxygen and prepare for rapid transport
What medication can you assist the patient with if indicated
Aspirin (if not contraindicated)
A 40-year-old female presents with a headache confusion and blurred vision. Her blood pressure is 220/130 mmHg. She is diaphoretic and has a slight wheeze on auscultation.
Hypertensive Emergency
A 65-year-old female post-MI presents with hypotension (BP 80/50 mmHg) cool clammy skin and a weak rapid pulse. She is confused and has difficulty breathing.
Cariogenic Shock
What should you do for a stable Angina patient
Administer oxygen if needed encourage rest and provide reassurance while preparing for transport
What is the first-line treatment for stable angina
Nitroglycerin (if no contraindications)
What is the most important intervention for a CHF patient
Administer oxygen and prepare for rapid transport to a facility with cardiac care
What is an additional treatment for CHF if available
CPAP (Continuous Positive Airway Pressure) to help reduce fluid buildup in the lungs
A 55-year-old male with a history of hypertension and smoking presents with severe chest pain radiating to his left arm. He is sweating and feels nauseous. His blood pressure is 170/100 mmHg heart rate is 98 bpm and he appears anxious.
Acute Myocardial Infarction
What is the primary treatment for an Aortic Dissection patient
Rapid transport to a trauma center with supportive care (oxygen IV fluids and monitoring)
What is the main danger of an aortic dissection
Aortic rupture which can lead to fatal internal bleeding
What is the primary concern with a Hypertensive Emergency patient
Risk of organ damage particularly to the brain heart and kidneys
What should be done for a Hypertensive Emergency patient
Initiate rapid transport to a hospital capable of managing hypertensive emergencies; avoid drastic lowering of the blood pressure
A 60-year-old female with a history of diabetes and hypertension reports chest pain when walking uphill which improves with rest. She states she’s had this type of pain on and off for the past few months.
Stable Angina
What is the first-line treatment for stable angina?
Nitroglycerin
A 75-year-old male presents with shortness of breath crackles in the lungs and swollen ankles. He has a history of heart disease. His blood pressure is 160/95 mmHg heart rate is 108 bpm and he appears to be in moderate respiratory distress.
CHF
A 50-year-old male reports a sudden severe tearing pain in his chest that radiates to his back. He is diaphoretic with a blood pressure of 180/110 mmHg and his pulse is 120 bpm.
Aortic Dissection
A 52-year-old male with a history of hypertension and high cholesterol complains of crushing chest pain radiating to his left arm nausea and sweating. His ECG shows ST-segment elevation in leads II III and aVF What is the likely diagnosis?
STEMI MI
What is the first step in management of Cardiogenic Shock
Administer oxygen and prepare for rapid transport to a hospital capable of advanced cardiac care
What is the key difference between cardiogenic shock and hypovolemic shock
Cardiogenic shock is due to the heart’s inability to pump effectively while hypovolemic shock is caused by severe blood or fluid loss
What immediate action should be taken in a STEMI MI
Administer oxygen and prepare for rapid transport to a hospital capable of performing percutaneous coronary intervention (PCI)
What is the role of aspirin in this scenario
To reduce clot formation and prevent further damage to the heart muscle
What is Acute Coronary Syndrome (ACS)
A group of symptoms caused by myocardial ischemia including angina and myocardial infarction
Difference between angina and myocardial infarction
Angina is temporary and relieved by rest/nitro; MI is more severe longer-lasting and not always relieved by nitro
What is cardiogenic shock
A condition where the heart cannot pump enough blood to meet the body’s needs (often due to MI)
What is congestive heart failure (CHF)
A condition where the heart fails to pump effectively causing fluid buildup in lungs or body
Key sign of aortic dissection
Sudden tearing chest or back pain with unequal pulses or blood pressures
When is oxygen indicated in chest pain
When SpO₂ is <94% or the patient is in respiratory distress or shock
What are red flags in chest pain assessment
Dyspnea nausea vomiting diaphoresis syncope abnormal vitals
Why is aspirin given in suspected MI
It prevents further clot formation by inhibiting platelet aggregation
What is the dosage of aspirin for chest pain
160–325 mg chewable (unless contraindicated)
How does nitroglycerin help in cardiac emergencies
It dilates coronary arteries and reduces heart workload
What are contraindications for nitroglycerin
Systolic BP <100 mmHg ED medication use within 24–48 hours or recent head injury
What is the importance of rapid transport in cardiac emergencies
Time is muscle—faster transport improves chances for PCI and survival
How often should vitals be reassessed in unstable cardiac patients
Every 5 minutes
Why is a calm environment important in cardiac emergencies
Reduces anxiety and myocardial oxygen demand
Why might women diabetics and elderly present atypically in MI
They may not have classic chest pain instead showing fatigue nausea or weakness
