Chapter 17 Cardiac Emergencies Flashcards
How many out of how many deaths does cardiovascular disease account for?
1 out of 3
What happens in ten minutes in cardiac arrest?
0-1 min: Cardiac irritability
0-4 min: brain damage not likely
4-6 min: brain damage possible
6-10 min: brain damage very likely
10+ min irreversible brain damage
What are the arteries of the body?
Carotid, subclavian, brachial, radial, femoral, and dorsalis pedis
What is cardiac output?
Cardiac output is the volume of blood that passes through the heart in one minute.
It is increased by increasing heart rate or stroke volume
What are the cardiovascular pathophysiology?
Ischemic heart disease-reduced blood flow, Atherosclerosis- Ca and cholesterol buildup in arteries
Thrombo-embolism: Blood clot floating through vessels
What are the cardiovascular diseases?
ACS: Acute coronary syndrome: caused by myocardial ischemia may be angina pectoris or acute myocardial infarction (AMI),
Cardiogenic shock-often caused by heart attack, and CHF- can’t keep up with the return of flow to from the atria: after MI, heart valve damage, chronic hypertension
Aortic aneurysm
What is angina?
When the heart’s demand for oxygen exceeds the supply, s/s similar to MI, serious warning signs
Symptoms “crushing, squeezing, standing on chest”
Radiation: midportion of chest under sternum, radiate to jaw, arms (frequently left arm), mid back , epigastrium 3-8min typically < 15min
Associated w/ dyspnea, nausea, sweating
Treatment: rest supplemental oxygen , nitroglycerin
What is AMI?
Acute Myocardial Infarction: immediate transport is essential because thrombolytics or angioplasty within 1 hour may prevent damage
-S/S: sudden {weakness, nausea, sweating}, chest pain “crushing/squeezing” that doesn’t change w/ breaths, lower jaw, back, abdomen, neck pain, irregular heartbeat, syncope, vomiting, abdominal pain (women), dyspnea, pink frothy sputum, sudden death
PA: Abnormal pulse (Faster, irregular, or slow), any kind of BP (decreased, normal or elevated), any kind of respirations (normal, rapid or labored), fear nausea, poor circulation, “Feeling of impending doom”
Leads to CHF, Cardiogenic shock, sudden death
What is the Levine sign?
A fist over the heart may indicate cardiac trouble
What are the similarities and differences of angina and AMI?
S: A: typically none, AMI: perspiration, pale grey color, nausea, weakness, dizziness, lightheadedness
E: A: extremes in weather, exertion, stress, meals, AMI: often none
P: A: Stop physical activity, decrease stress, nitroglycerine. AMI: nitro may give incomplete to no relief
Q: Dull or heavy discomfort with a pressure or squeezing sensation (AMI may be more intense than angina)
R: substernal or across the chest, radiate to neck, jaw, arms, back, shoulders
T: A: 2-15min, typically subside after activity stops MI: 10+min
What are the dysrhymias?
“heart rhythm abnormalities” premature ventricular contractions, tachycardia, bradycardia, ventricular tachycardia, ventricular fibrillation, asystole,
What can chronic hypertension lead to?
Stroke or dissecting aortic aneurysm
What is the difference between AMI a dissecting aneurysm?
AMI/DA
O: Gradual w/ additional symptoms/Abrupt w/o additional symptoms
Q: Tightness or pressure/sharp or tearing
R: Substernal (rarely back)/ between shoulder blades (back possible)
S: Increase w/ time/Maximal from onset
T: May wax and wane/Dones not abate
Clinical signs: Equal peripheral pulses/BP discrepancy b/w arms or decrease in femoral or carotid pulse
When do you give oxygen to a cardiac patient?
SpO2 <94%, dyspneic, hypoxemic, heart failure
How do you focus on the cardiac system?
Listen to lung sounds, JVD, dependent edema
