Complex Cardiovascular Flashcards
atherosclerosis
causes CAD, lipids accumulate in arteries, forming a plaque
normal total cholesterol
140-199
triglycerides
under 150
HDL
over 45
LDL
under 100
ACS symptoms
nausea, diaphoresis, SOB, anxiety, heartburn, fatigue, palpitations, pallor, dysrhythmias
what groups often have abnormal ACS symptoms
diabetics, elderly, females
atypical ACS symptoms
GI upset, fatigue, gray/blue, neck/jaw/back pain, upset stomach
stable angina
caused by buildup of plaque, chest pain lasting 5-10 minutes resolving in rest
unstable angina
unpredictable chest pain, occurs when plaque is beginning to rupture, often leads to MI
unstable angina symptoms
not relieved with rest, transient/no EKG changes, no biomarker elevation
variant angina
chest pain occurring when vessel spasms, typically @ rest or while sleeping
variant angina treatment
calcium channel blockers - verapamil, diltiazem, amlodipine
s/s of NSTEMI
ST depression, T wave inversion, elevated biomarkers
s/s of STEMI
ST elevation, T wave changes in 2 continuous leads
3 immediate steps in suspected ACS
assess presentation, 12 lead, biomarkers
troponin
released w cardiac necrosis
troponin T
less than 0, sex variations, raises with renal failure
troponin I
0-12; won’t raise with skeletal/renal damage
what should you give immediately with ACS
aspirin, nitro, morphine
other meds u may give with ACS
beta blockers, ACE inhibitor, high dose statin, heparin, Ca channel blocker
reperfusion techniques
fibrinolytics, CABG, PCI
ideal STEMI treatment
PCI
what to monitor for post cath
back pain, decreased UO, chest pain
post cath complications
myocardial ischemia/thrombosis, bleeding, hematoma formation
CABG post op equipment
A line, CVP, PA cath, chest tubes, pacing wires, vent, NG to LIS
CABG post op care
early ambulation, extubate within 3 hours, cough pillow, pain & glucose control, strict BP control, neuro checks
normal chest tube findings post CABG
up to 150ml/hour of blood
contraindications to fibrinolytic administration
pregnancy, home blood thinners, recent stroke/trauma, bleeding disorder
indications of improvement after fibrinolytic administration
improved chest pain, no ST elevation
indications of worsening after fibrinolytic administration
increased pain, dysrhythmias
side effects of fibrinolytics
bleeding - high risk of hemorrhagic stroke
s/s of pulmonary edema
increased O2 needs, cyanosis, anxiety, pink frothy sputum, cool clammy skin, accessory muscle use, suffocating
oxygenation interventions for pulmonary edema
CPAP/BIPAP, intubation
CPAP/BIPAP considerations
must be able to take mask off themselves - will aspirate if they throw up
medications for pulmonary edema
vasodilators, nitroglycerin, morphine
causes of endocarditis
pacemaker insertion, cardiac cath, prosthetic valve, dental work, IV drug use
endocarditis treatment
abx
myocarditis
usually from viral process & treated too late - manage CHF or dysrhythmias
pericarditis symptoms
pain at clavicular area, neck, scapula, friction rub, poor CO
pericarditis treatment
NSAIDs for pain, pericardiocentesis
valve regurgitation
valves don’t properly close, blood flows backward
valve stenosis
valves do not fully open, leaflets become stiff, hypertrophy occurs
possible cause of valve stenosis
endocarditis
symptoms of valve disorders
fatigue, DOE, chest pain, heart failure
medical management of valve disorders
oxygen, diuretics, manage dysrhythmias, abx
cardiac tamponade patho
accumulation of fluid in pericardial sac - heart is compressed, ventricles can’t fully fill
Beck’s triad
hypotension, JVD, muffled heart sounds
symptoms of cardiac tamponade
beck’s triad, tachycardia, elevated CVP, decreased UO, impending doom
cardiac tamponade treatment
emergent return to surgery - pericardiocentesis
dilated cardiomyopathy
enlarged LV, PVCs
hypertrophic cardiomyopathy
thickened, stiff LV walls
restrictive cardiomyopathy
LV contract & fills poorly
takotsubo cardiomyopathy
broken heart syndrome, weakened LV with severe stress, resolves on its own or progresses into HF
