Overview

Question 1

Intro

Answer 1

the most common cardiac problem paramedics see is chest pain

Other conditions related to cardiac problems include complaints of palpitations or syncope signalling the possible presence of cardiac disrhythmia

Question 2

Chest Pain

Answer 2

There are many causes of chest pain most of which are not life threatening, however a number of causes result in rapid deterioration and death

Treat all pts w/ chest pain w/ a high index of suspicion

*pts w/ life threatening causes may not appear ill initially

Question 3

Causes - potentially life threatening causes

Answer 3

• Acute coronary syndrome
• Acute myocardial infarction
• Unstable angina
• Myocarditis
• Pneumothorax
• Pulmonary embolus
• Aortic dissection - Aortic aneurysm
• Pericarditis w/ effusion

Question 4

Causes - other common causes

Answer 4

• Intercostal muscle pain
• Costochondritis
• Plueritic pain
• Bronchitis
• Cholecystitis
• Esophagitis
• Hiatus hernia
• Anxiety

*cardiac ischemia may not present as “pain” - pt can c/o nausea, light-headedness or sob

Question 5

Cardiac Disrhythmia - tachy

Answer 5

pts experiencing cardiac disrhythmia have the potential to deteriorate rapidly into cardiac arrest

Very rapid HR increases workload of the heart and increases oxygen demand

if the O2 demand cannot be met - the pt may develop chest pain from the ischemia

Rapid HR decreases ventricular filling time - resulting in decreased cardiac output which can lead to hypotension and hypoperfusion of myocardium

Question 6

Cardiac Disrhythmia - brady

Answer 6

Slow heart rates can be equally as lethal as the heart pumps too slowly to maintain blood pressure

These pts may complain of chest pain and/pr dizziness and show signs of hypotension/hypoperfusion

Question 7

Guiding Priniciples

Answer 7

paramedics must maintain a high index of suspicion for a cardiac related problem w/ pts c/o any of the following

• Chest discomfort
• weakness
• unattributable fatigue
• sob w/o hx of resp illness
• palpitations or a fluttering in the chest
• dizziness
• syncope

pts w/ myocardial ischemia and other cardiac related problems may benefit from starting tx in the field but this should not delay transport