CV Emergencies Lecture Flashcards
Pericarditis is pleuritic like central CP that worsens with ___________ and improves with ________
Worsens when pt is supine
Imroves with sitting
Pericarditis is aggravated by..
1.
2.
3.
Movement
Coughing
Swallowing
MC cause of pericarditis?
Viral!
(Coxsackie)
What will you hear during a lung exam in a pt with pericarditis
Friction Rub
3 Ps of pericarditis?
Position
Palpation
Pleuritic
Duration= hours to days
Quality= sharp
Pericarditis
- *1. Viral**
2. Uremia
3. Radiation
4. Autoimmune
5. Drug induced
6. Trauma
7. Early post MI
8. Neoplastic
causes of pericarditis
True or False..
other, less common causes of pericarditis, include:
TB, acute bacterial infections, fungal
True
ECG changes occur within hours of onset of pain
initial changes= diffuse ST segment elevation in ALL leads EXCEPT aVR and VI
later changes= normalization of ST elevation followed by T wave flattening and T wave inversion (this can be days or longer)
Pericarditis
All pericarditis pts should get what image, because there may be a small effusion
Echo-doppler
Tx of pericarditis..
Bedrest
NSAIDs
**avoid oral anticoagulation!
Mortality rate in diagnosed cases = 8%
Mortality rate in undiagnosed cases= 40-50%
PE
Risk factors:
Stasis (pregnancy, obesity, varicosity, bed rest, immobilization, surgery, incresed age)
Cardiac D/Os
Hypercoagulability (OCPs, polycythemia, Factor V Leiden, etc)
Trauma
Chemo
Smoking
PE
97% will have at least 1 of the following:
Tachypnea
Dyspnea
Pleuritic CP
PE
*1/3 will have tachycardia
ST, NSST-T Changes on ECG
O2 may be decreased; repiratory alkalosis
CXR often normal
D-Dimer is non specific
PE
Image of choice for PE?
Helical (Spiral) CT Angiography
Pain (deep, visceral, crushing, heavy squeeze) longer than 30 mins
+
diaphoresis
..should be highly suspicious of?
MI
Can be caused by….
CAD
Plaque rupture
Occlusive thrombus
No perfusion of effected myocardium
MI
Atypical presentation of MIs are commonly seen in….
Elderly
Women
Diabetics
If a person is having an MI, is there pulse and BP high or low?
Can be either!
*usually depends on what type of MI they are having (location)
The sympathetic NS is stimulated, causing
increased pulse
increased HR
..usually seen in what type of MI?
Anterior MI
Parasymp NS is stimulated, casuing a
decreased pulse
decreased BP
..usually seen with what type of MI?
Inferior MI
An S3 heart sound during an MI indicates ______ dysfunction
LV
Transient MR murmur with an MI indicates _________ dysfunction
Papillary muscle