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CEN Cardiovascular Emergencies > Myocardial Ischemia > Flashcards

Myocardial Ischemia Flashcards

1
Q

1st sign of CAD

A

Stable Angina

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2
Q

What is CAD

A

Any disease that narrows or occludes one or more cornary artery

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3
Q

When does stable Angina present

A

50% or more occlusion

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4
Q

What happens to angina pain?

A

Goes away quickly with rest or nitro

ST depression can be when pain is present

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5
Q

Cardiac Enzymes in Stable angina

A

Normal

Released from dead cardiac cells - no cardiac ischemia here

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6
Q

Unstable Angina occurs at

A

80% or greater occlusion

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7
Q

Unstable Angina can happen

A

at rest or minimal activity

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8
Q

Unstable Angina can have what on EKG

A

T wave inverisons- indicate a prolonged ischemia >20 mins

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9
Q

What cardiac enzymes are w/ unstable angina

A

None - again no cellular death

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10
Q

What begins to happen to cells at NSTEMI

A

Cell death

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11
Q

NSTEMI occurs at

A

95% or greater occlusion

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12
Q

NSTEMI EKG changes

A

ST depression or T wave abnormalities - but not classi

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13
Q

NSTEMI SA

A

Pain

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14
Q

STEMI EKG

A

ST segment elevation

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15
Q

what happens when you have a blockage of your LAD

A

Blockage of the front of your left ventricle

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16
Q

STEMI leads

A

v3 and v4

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17
Q

Frequent presentation of an LAD Anterior MI

A

Left ventricular failure - can’t pump, front wall not compressing against the back

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18
Q

Where does Circumflex artery go?

A

Under your arm - lateral/side part of your heart

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19
Q

What leads go on circumflex artery

A

V5 & V6

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20
Q

What does the circumflex artery do during a lateral MI

A

Buldges - can’t compress

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21
Q

Presentation of circumflex lateral MI

A

Cardiogenic shock

22
Q

R ventricle sits beside

A

the mediumstinum

23
Q

Where does the right marginal artery sit?

A

Bottom of your heart

24
Q

What is another name for right marginal artery MI

A

Inferior MI

25
Q

Artery that gives main blood source to AV Node

A

Right Marginal Artery

26
Q

3 leads for inferior MI

A

II, III, aVF

27
Q

Inferior MI complications

A

Heart blocks - main blood source for AV node

28
Q

Posterior Descending Artery causes

A

blockage of back of heart

29
Q

Can you see EKG changes on posterior MI?

A

No you don’t put leads on the back

30
Q

What happens during posterior MI for contracility

A

Right posterior side buldges - can’t contract

Shows signs of RV failure

31
Q

What happens to R wave in posterior MI

A

R wave goes from big to small - R wave progression

Tall V1
Small V6

32
Q

MI V7, V8. V9?

A

EKG being done on back below scapula

Posterior MI

33
Q

Vagal nerve runs from…

A

Down mediumsteinum, border Right ventricle on the way to the diaphragm - hugs R ventricle

34
Q

What can happen to the vagal nerve during a Right Ventricle MI

A

Ischemia can irritate the vagal nerve and cause parasympathetic stiumulation

35
Q

What does Left Ventricle MI stimulate?

A

Left sided heart has a decrease in CO therefore stimulating sympathetic

36
Q

Nausea/Vomiting

A

Right Side

37
Q

JVD

A

Right Side

38
Q

Diaphoresis

A

Left Side

39
Q

Dyspnea/Orthopena

A

Left Side

40
Q

Tachycardia/HTN

A

Left Side

41
Q

Bradycardia/Hypotension

A

Right Side

42
Q

Electrode placement for right sided MI

A

Move the left sided stickers to the right side

43
Q

O2 be put on both R and L MI?

A

Yes - for 02 sat of 92%

44
Q

ASA for both R and L MI?

A

Yes - chewable 162-325

45
Q

NTG spray or SL for both R and L MI?

A

ONLY RIGHT
Vasodilator

Contraindicated in a pulse >50 and SBP >90

46
Q

When should you not use nitro for an Left sided MI?

A

IF a phosphodiesterase (Cialis / Viagra) inhibitor has been used within the past 24 hours

  • Hypotension refractory to tx
47
Q

If Left MI does not respond to nitro?

A

Morphine

48
Q

Fluid boluses for L or R MI?

A

R because vasodilation - pressure is low - elevate pressure

49
Q

Percutaneous Coronary Interventions for L or R MI?

A

Both - Tx less than 90 mins from onset of pain

50
Q

Fibrinolytic for L or R MI?

A

Both - IF PCI is delayed

51
Q

What is PCI

A

Stent placement into narrowing blood vessels due to plaque build up

CEN Cardiovascular Emergencies (13 decks)

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