Final Flashcards
Stable angina
Worse when physically active
RELIEVED BY REST
Unstable angina
Occurs with rest
What is treatment for STEMIs
PCI is the insertion of a catheter with a ballon tip that is inflated to open a artery
Who is a PCI more reserved for
More reserved for patients with STEMIs but, non STEMI patients may also have one
Stemi
Full occlusion of the coronary vessel
Non stemi
Platelets aggregate and cause blockage of smaller vessels leading to a non stemi
ACS
Is the clinical manifestation of coronary heart disease, which includes the developement of fatty plaques in the coronary arteries
What are biochemical markers that help diagnose an infarction
Troponin
Myoglobin
CPKMB
Cardiac catherization
Is performed to determine the exact location of the myocardial injury and specific obstructions to the coronary vasculature
What is cardiac catherization most commonly used for
For the diagnosis of CAD and ACS
IT is useful in determining whether a patient would benefit from a PCI or CABG
What is the most commonly used anticoagulant for patients with ACS
Heparin
What is aftercare of PCIs
Patients with stent placement usually require anti platelet therapy with aspirin or clopidogrel for up to 6 months to reduce the risk for vessel thrombosis
What are the 3 prominent signs of cardiac tamponade
Remember BECKS TRIAD
- Distended heart sounds
- Distended jugular veins
- Decreased arterial pressure
Cardiac tamponade
Is compression of the heart resulting from fluid or blood within the pericardial sac
What is cardiac tamponade are usually the result of
Blunt or penetrating trauma to the chest
Cardiac catherization
Angiographic procedures
Pacemaker insertion
What are other signs and symptoms of cardiac tamponade
Chet pain Tachypnea Dyspnea Tachycardia in response to low CO pulsus paradoxus Hypotension
What is pulsus paradoxus
Systolic pressure that is markedly lower during inspiration
What are assessment findings of cardiac tamponade
A echocardiogram is performed to confirm the disease and quantify the amount of pericardial fluid
CXR
What is medical mgmt of cardiac tamponade
Pericardiocentesis
How is the HOB placed during a Pericardiocentesis
45-60 degrees, placing the heart in proximity to the chest wall so that the needle can be inserted directly into the pericardial sac
Pacemaker
Is a medical device designed to assist in stimulating the heart when the natural pacemaker is too slow or its impulses are blocked from reaching the ventricles
Demand pacemaker
Is synchronized with the persons HR, meaning that it fires when the HR drops below a preset amount
What are pacemakers used for
Severe bradycardia
Dysthymias
Sometimes ventricular dysthymias
What are complications of ICDs and pacemakers
Cardiac tamponade
ICDs are used in who
Used in patents who r at risk of sudden cardiac death due to VF, or those patients who have experienced one or more episodes of VTor VF unrelated to a MI
What do ICDs do
It is programmed to deliver an electric shock if the pt goes into VF
It monitors the patients HR and rhythm and is multi programmable to deliver pacing, cardioversion and or defibrillation according to the patients needs it can also pace the heart if severe bradycardia occurs
What is CABG
A procedure in which the patients diseased coronary arteries are bypassed with the patients own venous ( saphenous vein) or artery ( internal mammary or radial) vessels.
Who is CABG indicated for
Patients with ACS to relieve symptoms, improve quality of life and to hopefully prolong life
Who is CABG indicated for
Ppl who have failed medical tx
Has more than 2 diseased coronary vessels with significant blockage
May not be a candidate for PCI
has failed a PCI attempt with ongoing chest discomfort
Post op care for CABG
Apply a cardiac monitor
Monitor the volume in the circulatory system which is reflected by RAP and PCWP
Cardiogenic shock
A hemodynamic problem
A problem within the heart itself
What is cardiac tamponade are usually the result of
Blunt or penetrating trauma to the chest
Cardiac catherization
Angiographic procedures
Pacemaker insertion
What are other signs and symptoms of cardiac tamponade
Chet pain Tachypnea Dyspnea Tachycardia in response to low CO pulsus paradoxus Hypotension
What is pulsus paradoxus
Systolic pressure that is markedly lower during inspiration
What are assessment findings of cardiac tamponade
A echocardiogram is performed to confirm the disease and quantify the amount of pericardial fluid
CXR
What is medical mgmt of cardiac tamponade
Pericardiocentesis
How is the HOB placed during a Pericardiocentesis
45-60 degrees, placing the heart in proximity to the chest wall so that the needle can be inserted directly into the pericardial sac
Pacemaker
Is a medical device designed to assist in stimulating the heart when the natural pacemaker is too slow or its impulses are blocked from reaching the ventricles
Demand pacemaker
Is synchronized with the persons HR, meaning that it fires when the HR drops below a preset amount
Cardiogenic shock
A hemodynamic problem
What are signs and symptoms of cardiogenic shock
Decreased CO
Decreased BP
increased SVR
What is hypovolemic shock
A fluid deficit problem
Decreased fluid in the intravascular space
What are causes of hypovolemic shock
Decreased CO
Decreased BP
increased HR
What are causes of hypovolemic shock
Dehydration
Trauma
What is distributive shock
ADEQUATE BLOOD AND FLUIDS THAT ARE DISTRIBUTED ABNORMALLY, the patient will still have decreased CO, but not bc of decreased fluid
What is treatment for distributive shock
Fluid won’t help, you must correct the u deflating cause
What is obstructive shock
It is related to the heart
The ventricles don’t fill or empty adequately
It’s a ventricular problem
Cardiac tamponade causes which type of shock
Obstructive shock
What is anaphylactic shock
A hypersensitivity reaction to drugs or food
It affects CO bc of massive vasodilation
How do you treat anaphylactic shock
Treat the cause, epinephrine l, iv steroids and Benadryl won’t help