Exam 2 Flashcards
Who is at risk for HF?
HTN & CAD
Males, African American, obesity, DM, stress, hyperlipidemia, ETOH, inactivity
S & S of HTN
HA, fatigue, dizziness, palpitations, SOB
CAD Risks
Smoker, HTN, inactivity, DM, stress, hyperlipidemia, native American, African American, family Hx
S&S of Heart Failure
Tired, fatigue, SOB, palpitations, edema, weight gain
Angina means
That there can be a perfusion problem to cardiac muscle
Stable angina
Knows what caused it, how to fix it, predicatable, same pain every time
Unstable angina
New pain, at rest or activity, came on with less effort than normal.
longer duration usually more than 10-15 min
Pain persists after Nitro
Awakens from sleep
Unstable angina symptoms
SOB, nausea, dizziness, palpitations, radiation from jaw to arm.
NSTEMI
non-ST elevated MI
Partial occlusion of vessel
STEMI
ST elevated MI
Total occlusion of vessel
Collateral circulation
When blockages occur over time, vascularature binds collaterally to avoid blockage.
How is a diagnosis for Acute Corinary Syndrome (ACS) made?
S&s
Risk factors
EKG
Troponin
(T)less than0.1
(I)less than 0.03
3 sets, 3-6hrs apart (Degree of injury)
cardiac catheterization
FLP, CRP, BNP, chemistry, coags, CBC,
CXR, Echo, TEE, Stress Test
SA node aka
anatomical pacemaker
The time it takes for the impulse to go through the atrium causing depolarization (contracting)
🫛P wave
0.06-0.12 seconds
Time taken for the impulse to travel through the atria, AV node, bundle of HIS, bundle branches & pirkinje fibers until just before ventricular contraction
PR interval
0.12-0.20 seconds
The time taken for ventricular depolarization (contraction, the beginning of systike
QRS interval
<0.12 seconds
Ventricles return to resting state, corresponds with diastole when chambers are refilling
T wave
ST deviation above by more than 1mm =
Injury
ST deviation below by more than 1mm=
Ischemia
ST segment =
Diastole
1mm small square =
0.04 seconds
5 small squares or 1 large square =
0.2 seconds
Calculate HR
Small boxes
Rwave to Rwave /1500= HR
Sinus Bradycardia
HR below 60
Nonsymptomatic- athlete, sleep? Vagal maneuver
If symptomatic may push Atropine
💊doesnt help- transcutaneous pacing
Dopamine or epi infusion
May need pacemaker
Sinus Tachycardia
HR 100-150
Considerations:
Stress,Pain, Anemic, hypovolemic, epi, coffee?
Stable- vagal maneuver
Beta blocker, calcium channel blocker
Unstable- synchronized cardioversion
MI Atypical manifestations
Weakness, nausea, indigestion, SOB
Women- back pain
Diabetics- silent d/t neuropathy
Geriatric- SOB, pulmonary edema, dizziness, dysrhythmia, altered mental status
Ashen, clammy, cool to touch
MI clinical manifestations
BP & HR ⬆️then ⬇️
Crackles
JVD
Hepatic enlargement
Peripheral edema
Distant 🩵 sounds
N/V
Fever
Ventricular Tachycardia
EKG- tombstone, wide QRS, 100-120p
Cause: Electrolyte imbalance, MI, stimulants
S&S: can be awake, chest pain, palpitations, syncope
Pulse: Amidodarone💊, synchronized cardioversion
Pulseless: CPR, D-Fib🚨, epi, amiodarone, vasopressin 💊
VT can lead to V-Fib 💀🚨
Ventricular Fibrillation
EKG: rapid, unorganized, no pulse
Cardiac injury, loss of consciousness
Treatment: CPR, D-Fib, possible intubation
Drugs: Epi, Amiodarone, Bicarb
Synchronized Shock is given to
A-Fib
Stable- has a QRS complex
Shock delivered during R wave 🌊
Defibrillation is given to
V-Fib or pulseless V-Tach
Need AED🔋
CPR
Atrial Fibrillation
EKG: irregular, unknown p wave (atrial problem)
Causes- HF, COPD, HTN
S&S: Tachy, palpitations, dizzy, fatigue
(Due to ⬇️oxygen)
Stable: 💊Beta Blockers, CCB, Amiodarone, Eliquis🩸
Unstable: Synchronized Cadioversion
Premature Ventricular Contractions
EKG: inverted QRS
Cause: HF, Stress, 💊, ☕️, 🍷, pain
Treatment: ⬇️stress, ☕️, 💊
S&S: skipped heartbeat
ASystole
EKG: flat
Causes: MI, HF, cardiac Tamponade
Treatment: CPR
Do NOT shock 🛑
Atrial Flutter
EKG: Sawtooth, can’t tell P wave 🌊
Cause: CAD, HTN, PE,
S&S: fatigue, low BP, palpitations
Stable: CCB, Amiodarone, Eliquis 💊
Unstable: synchronized cardioversion
🛑do NOT shock!
Supraventricular Tachycardia
EKG: no P wave, Tachy (151+)
Cause: Wolff Parkinson White, stress, electrolyte
S&S: ⬇️BP, SOB, chest discomfort
Stable: valsalva🚽, Adenosine💀, Beta blocker, Cardiac Ablation, Digoxin
Unstable: Synchronized cardioversion
MI EKG
ST elevation - no oxygen (STEMI)
ST depression- low oxygen
