Pathophys Flashcards
prinz metal angina
caused by coronary vessle vasospasm
stable angina
sudden onset
3-5 min lasts
releived with rest and nitro
unstable angina
sudden onset
initated during rest
lasts longer than 20 min
may not resolve with rest or nitro
transmural mi
q wave will be present.
goes through entire thickness of myocardium
subedorcardial
q wave not present.
partial thickness
1 cause of death from MI
dysrhythmia
levine sign
clenched fist over cehst
atypical presentation of mi
diabetics
chronic hypertension
elderly
female
1 cause of RHF
LHF
5 life threats of cp
mi pe aortic dissection tamponade pneumothorax
becks triad
hypotension
jvd
muffled heart tones
managment of cardiac tamponade
o2 to 94
fluid 30 ml/kg
dopamine
pericardiocentesis
causes of cardiogenic shock
mi left sided hf tension pneumo cardiac tampnoade cardiac contusion
systolic <80 resp distress cp weakness ams tachycardia
cardiogenic shock
cardiogenic shock management
treat underlying problem
fluid based on lung sounds
consider positive inotrops
hypertensive emergency requirement
uncontrolled hypertension greater than 180
tearing sensation on chest or back
dissecting aortica aneurysim (red flag on nremt)
syncope absent or reduced pulses unequal bp unequal pulse tearing sensation flank pain scapular pain radiation into lungs
dissecting aortic aneurysm
normal axis deviation
0-90
vector will point towards hypertrophy
away from infarct
right atrial abnormality
dilation of right atrium from elevated venous pressure or high pulmonary pressure
p wave bigger than 2.5mm in lead 2 or 1.5 mmm in lead 1
left atrial abnormality
p wave normal height but prolonged duration. means valvular heart disease
RVH
caused by pulmonary hypertension.
in v1 R wave taller than s wave
LVH
caused by systemic hypertension.
sum of depth of s wave in v1 and r wave in 5 or 6 exceedes 35 mm
unstable angina on 12 lead
st depression of .5 mm in 2 contiguous leads
benign early repolarization
mimicks st elevation
j or fishook appearance to j point and a concave st segment morphology in v4 v6 and inferior leads
st elevation (less than 5 mm in multiple leads. depressed or downslopin pr segment.
chest pain is positional***
pericarditis-
inflammation of pericardial sac
positional chest pain
s1q3t3 pattern
deep s wave in lead 1
deep narrow q wave in lead 3
t wave inversion in lead 3
s1q3t3
new rbbb
st depression in 123
PE
osborne wave
shivering on 12 lead
hypothermia
tall peaked t waves. p waves become flattened and eventually disappear
maybe wide qrs
hyperk
flat or absent t waves
u wave
hypokalemia
u wave
small deflection after t wave
shortened qt interval means
hypercalcemia
long qt interval means
hypocalcemia
dilated cardiomyopathy
heart muscle becomes weak diminishing its ability to pump enough blood through the body
hypertrophic cardiomyopathy
myocardial wall becomes thick. usually diagonsed in 30s and 40s
brugada syndrome
rare genetic disorder affecting sodium channels in heart
long qt syndrome
qt interval longer than .45
heart is experiencing an extended refractory period.
deeply inverted symmetric t waves in precordial leads and prolonged qt interval
intracranial hemorrhage
if ekg shows it then pt has symptoms
atherosclerosis
buildup of calcium and cholesterol inside walls of arteries
atheroma
mass of fatty tissue that gradually calcifies hardening into atheromatous plaque
heavy crushing pain radiates to left arm also goes neck jaw upper back epigastrium not affected by breathing or movement may show levine sign
acs
plasmin
activates plasminogen which dissolves clot
cor pulmonale
heart disease that develops because of chronic lung disease. usually secondary to copd
tachycardia pulsus alternan(strong and weak beats) crackles cough with frothy sputum third heart sound paroxysmal nocturnal dyspna orthopnea (positional dyspnea) pulsus parodoxus
lvf
weight gain ascites swelling jvd liver enlargment spleen enlargment nausea
RVF
causes of cardiac tamponade
aortic dissection blunt trauma mi heart surgery hypothyroidism renal disease
pt will often be to ill to answer questions
cardiac tamponade treatment
if no signs of hf give fluid
pericardiocentesis
cardiogenic shock ss
compensated: crackles jvd peripheral pulse weak and rapid skin pale and mottled, cool and moist narrow pulse pressure
decompensated is same but with altered mental status
cardiogenic shock treatment
1-200 ml of fluid stop if crackles appear
dopamine, epi, norepi titrated to 90 sys
hypertensive emergency
acute elevation of bp with end organ damage
hypertensive encephalopathy
acute hypertensive crisis. sudden escalation to above 200/130
when map gets dangerous
150 can breach blood brain barrier
1/3rd difference of sbs and dbp added to dbp
first sign nv and headache
then seizures blindness or aphasia
endocarditis
infection of lining of heart
can damage heart valves
fever and chills
loss of apetite weight loss joint ache sob cough
red and blue lesions on palms and soles
endocarditis
valvular stenoissi
heart must work harder to pump through narrowed vavles
pericarditis causes
viral, bacterial, fungal
heart surgery
heart attack
flu like symptoms
stabbing pain
made worse by deep breathing coughing, laying flat. made better when sitting up
fever, tachycardia, tachypnea, jvd
pericarditis
myocarditis
inflammation of myocardium
caused by viral infection, rheumatic fever, chemical poisons, alchoholism
rheumatic fever
causes stenosis of mitral valve and aortic valve
scarlet fever
caused by same bacteria as strep throat. strawberry tongue
dangerous to infants
sudden onset pain. sense of impending doom tearing ripping sensation max pain immediatly does not stop bp discrepency
aortic aneurysm
acute arterial occlusion
sudden onset and disruption of blood flow because of thrombus or trauma to artery
pale mottled skin on limb when raised
turns red when lowered below heart
sensory issue in limb
acute arterial occlusion
claudication
pain or cramping in legs during activity
dvt
blood clot in vein.
risk factors for dvt
pregnant or immobile for long periods of time.
damage to inner lining of vessle
dehydration, oral contraceptives hormone replacement therapy
