EMT test #2 part 2 Flashcards
Atherosclerosis: What
Calcium and fatty material, called cholesterol, form plaque and build up in the walls of the artery. This can cause occlusion, or blockage of a coronary artery.
Atherosclerosis: Why
High blood pressure, smoking, or high cholesterol.
Atherosclerosis: s/s
Age, diet, blood pressure. Heart attack and stroke symptoms. (Can cause both)
Atherosclerosis: Leads to
Ischemia, thromboembolism, embolism
Thromboembolism: what
Blood clot that travels through blood vessels until it reaches an area too narrow to pass. This causes hypoxia in tissues downstream. If this occurs in a coronary artery, an acute myocardial infarction will occur.
Thromboembolism: why
When a piece of plaque in an atherosclerotic artery breaks off, it signals a blot clot to form. When it moves down the blood vessel it becomes a thromboembolism.
Thromboembolism: s/s
Chest pain Syncope (fainting) Sense of doom Tachycardia Normal respirations Dyspnea Cough Tachypnea Fever Cyanosis
Thromboembolism: leads to
Ischemia
Ischemia: what
Inadequate supply of blood to the heart muscles.
Ischemia: why
Atherosclerosis, blood clot, coronary artery spasm.
Ischemia: s/s
Neck/jaw pain Shoulder, arm pain Tachycardia Fatigue Dyspnea Nausea/vomiting Diaphoretic
Ischemia: treatment
Aspirin
Ischemia: Leads to:
Angina Pectoris, Acute Coronary Syndrome
Angina Pectoris: what
The pain felt when heart tissues aren’t getting enough oxygen. This is a symptom of atherosclerotic coronary artery disease. Stable angina goes away after treatment. Unstable angina can be caused even when resting and can lead to an AMI.
Angina Pectoris: Why
This occurs when the hearts need for oxygen exceeds its supply. This need can be caused by physical or emotional stress, a sudden fear, or a large meal, cold temperatures, or cocaine use. When increased oxygen demand goes away it usually goes away
Angina Pectoris: s/s
Crushing, squeezing feeling in the chest. Pain felt in the jaw, left arm, midportion of the back. Pain lasts 3-8 minutes with 15 as the max.
Angina Pectoris: treatment
Rest, oxygen, nitroglycerin.
Acute Coronary Syndrome: what
Reduction in blood supply to heart muscles. This can either be angina pectoris (just pain) or an AMI (tissue dying). Signs and symptoms are similar and are treated the same.
Acute Coronary Syndrome: why
Caused by a blockage in the coronary arteries. Smoking, high blood pressure, high blood cholesterol, diabetes, physical inactivity, being overweight or obese, family history of chest pain, heart disease, or stroke.
Acute Coronary Syndrome: s/s
Chest pain/pressure, pain or discomfort in one or both arms, the jaw, neck, back or stomach, dyspnea, dizzy, lightheaded, nauseous, sweating. Pain when exercising.
Acute Coronary Syndrome: leads to
Leads to: AMI when heart tissues begin to die because of occlusion.
Acute (sudden) Myocardial (muscular tissue of the heart) Infarction (death of tissue): what
The death of cells in the area of the heart where blood flow is obstructed. Dead cells can’t be revived and turn into scar tissue that budens a beating heart. This starts to happen 30 minutes after blood flow is cut off. After 4-6 hours, you will die. More likely to happen in the left ventricle because it require more blood. Pain is different from angina pain. May not always be from exertion. This could last 30 minutes to several hours.
Acute (sudden) Myocardial (muscular tissue of the heart) Infarction (death of tissue): why
Restriction of blood flow due to atherosclerosis and/or thromboembolism
Acute (sudden) Myocardial (muscular tissue of the heart) Infarction (death of tissue): s/s
Chest pain/pressure Arm, neck, back, jaw, stomach pain Syncope (fainting) Dyspnea Nausea/Vomiting Weakness Pink, frothy sputum Cyanotic/Pale Sudden Death Normal respiratory Slightly elevated blood pressure Frightened/Feeling doom
Acute (sudden) Myocardial (muscular tissue of the heart) Infarction (death of tissue): treatment
Thrombolytics, angioplasty, nitroglycerin, aspirin, beta blockers.
Acute (sudden) Myocardial (muscular tissue of the heart) Infarction (death of tissue): leads to
Sudden death, cardiogenic shock, congestive heart failure
Congestive Heart Failure (CHF) : what
Failure of the heart. After an AMI or because of long standing high blood pressure. (Over months) Starts between first few hours or days of a heart attack. The lungs become congested with fluid
Congestive Heart Failure (CHF) : why
The ventricular heart muscle is too permanently damaged and can’t keep up with the return flow of blood from the atria. Occurs after an AMI or because of long standing high blood pressure.
Congestive Heart Failure (CHF) : s/s
Chest pain Syncope (fainting) Severe weakness Dysrhythmia/Tachycardia Dyspnea Pink/foamy sputum Dyspnea from lying down Edema (swelling) in legs. Rales, crackles
Congestive Heart Failure (CHF) : treatment
1) Take vital signs,
2) Nonrebreathing mask at 10-15 L.
3) Contact medical control/local protocols to use CPAP.
4) Legs down, facing upright.
5) Calm anxiety.
6) Gather medications for ED.
7) COntact medical control for nitroglycerin.
Congestive Heart Failure (CHF) : leads to
Dependant Edema. Blood begins to back up due to the ventricles inability to move it out. This blood seeps into the lungs from the capillaries and rales can be heard.
Pulmonary Edema: what
Fluid in the lungs
Pulmonary Edema: why
During congestive heart failure, the lungs begin to fill with fluid because the left side of the heart fails to pump adequately. Blood backs up in the pulmonary veins, increasing the pressure of the capillaries in the lungs. When that pressure gets too high, water enters into the alveoli (pulmonary edema). This occurs suddenly after an AMI or over months as in chronic CHF (congestive heart failure).
Pulmonary Edema: s/s
Chest pain Cyanosis Diaphoretic Irregular/rapid heartbeat Dyspnea Pink/foamy sputum Dyspnea from lying down Edema (swelling) in legs. Drowning/suffocating
Cariogenic Shock: what
A lack of blood flow that leads the heart to fail. (Hypoxia of the heart)
Cariogenic Shock: why
this is caused after an AMI when the heart muscles don’t get enough oxygen.
Cariogenic Shock: s/s
Tachycardia Hypotension Pulmonary Edema Cyanosis Weak pulse Irregular pulse Low Cardiac Output Anxiety Rales Cold, Clammy skin Chest Pain
Cariogenic Shock: treatment
Give oxygen, keep warm, epinephrine.
Cariogenic Shock: leads too
Stroke, dissecting aortic aneurysm
Hypertensive Emergency: what
Systolic blood pressure greater than 180 mm HG. Can lead to a stroke or a dissecting aortic aneurysm.
Hypertensive Emergency: s/s
Sudden severe headache Bounding pulse Ringing in ears Nausea/vomiting Dizziness Warm skin, wet or dry Nose bleed Altered mental status Development of Pulmonary Edema
Hypertensive Emergency: treatment
Make patient comfortable and monitor blood pressure frequently. Elevate head and rapid transport. Consider ALS as paramedics can use meds to lower blood pressure.
Hypertensive Emergency: leads to
Stroke, dissecting aortic aneurysm.
Aortic Aneurysm: what
Weakness in the wall of the aorta. The aorta is susceptible to rupture due to dilation of the aorta.
Aortic Aneurysm: why
Uncontrolled hypertension
Aortic Aneurysm: s/s
Sudden chest pain, full force, different blood pressure between arms.
Dissecting Aneurysm: what
Blood flowing through the layers of the artery wall
Dissecting Aneurysm: why
The inner layers of the aorta become separated. This is because of uncontrolled hypertension.
Dissecting Aneurysm: s/s
Sudden chest or back pain between the shoulder blades. Stabbing feeling.
Dissecting Aneurysm: leads too
Aortic rupture, sudden death.
Dysrhythmia: Ventricular Tachycardia
Describes a very rapid heart rhythm, at 150 to 200 beats/min. The electrical activity starts in the ventricle instead of the atrium. This doesn’t allow enough blood to fill in the ventricle, therefore blood pressure may fall or pulse may be lost altogether.
Dysrhythmia: Ventricular Fibrillation (V fib)
Describes the disorganized, ineffective quivering of ventricles. No blood is being pumped to the body. The only way to treat this is to defibrillate the heart. Survival diminishes 10% every minute until defibrillation.
Acute stroke (Cerebrovascular Accident): what
Interruption of blood flow to an area within the brain that results in a loss of brain function.
Dyspnea/Nocturnal dyspnea:
Shortness of breath. Nocturnal dyspnea causes you to wake up in the night short of breath and is caused by CHF, asthma, COPD
Hypertension (HTN)/Hypotension:
Hypertension is blood pressure that is too high. (Above 130/80)
Hypotension is blood pressure that is too low. (Below 90/60)
Return of spontaneous circulation (ROSC)
Restoring a heartbeat after AED. Maintain breathing and an oxygen saturation of 94%-99%. Take blood pressure and ask them to perform simple command like squeeze my finger.
Left Sided Heart Failure
When the left ventricle fails to pump adequately, fluid may back up in your lungs, causing shortness of breath. Often leads to right sided HF.
Right Sided Heart Failure
As a result of left sided failure, fluid may back up into your abdomen, legs and feet, causing swelling. Lower body swelling is called dependant edema.
Ischemic Stroke: What
Blood flow to the brain is compromised due to a blockage.
Ischemic Stroke: Why
Caused by atherosclerosis.
Ischemic Stroke: s/s
Severe headache Facial droop Unilateral Numbness Weakness/Paralysis Altered level of consciousness Vision problems
Hemorrhagic Stroke: what
Caused by bleeding in the brain
Hemorrhagic Stroke: why
Applies pressure to the surrounding blood tissue, compromising oxygenation in the brain.
Cariogenic Shock: what
A lack of blood flow that leads the heart to fail. (Hypoxia of the heart)
Cariogenic Shock: why
This is caused after an AMI when the heart muscles don’t get enough oxygen.
Cariogenic Shock:s/s
Tachycardia Hypotension Pulmonary Edema Cyanosis Weak pulse Irregular pulse Low Cardiac Output Anxiety Rales Cold, Clammy skin Chest Pain
Cariogenic Shock: leads to
Stroke, dissecting aortic aneurysm
Cariogenic Shock: treatment
Give oxygen, keep warm, epinephrine
