Tech Recognition and Management of cardiac conditions Flashcards
Name 4 Types of Cardiac Condition
Coronary Artery Disease
Acute Coronary Syndromes (Unstable angina and acute myocardial infarction)
Heart Failure
Cardiac Arrest
sickle cell
MI stem
nistem
Coronary Artery Disease
Atheroma (laying down of fatty deposits)
+ Sclerosis (Hardening of plaque) = Atherosclerosis (deposition of atheroma combined with hardening of the coronary arteries) ↓ Decreased blood flow
Angina Pectoris
The most common symptom of coronary artery disease Caused by temporary lack of oxygen and an accumulation of carbon dioxide and lactic acid in the myocardium during a period of increased oxygen demand Frequently related to exertion – painful symptoms revert when the exertion ceases
Name 2 types of Angina Pectoris
2 types: Stable Angina
Unstable Angina (Acute Coronary Syndrome)
Describe Stable Angina
Generally predictable Follows a recurrent pattern Precipitated by exertion and/or emotion, producing pain of similar intensity, duration and location Most attacks are relieved by rest and/or nitrates within 2-3 minutes
Describe unstable Angina (ACS)
More serious, indicates increasing obstruction of the coronary arteries Unpredictable Noticeable changes in frequency, intensity or duration of pain May occur at rest and even during sleep, waking the patient Often precedes an Acute Myocardial Infarction Sometimes referred to as pre-infarction or crescendo angina
Referred Pain
Nerves from damaged heart tissue convey pain signals to spinal cord levels T1-T4 on the left side, which happen to be the same levels that receive sensation from the left side of the chest and part of the left arm. The brain isn’t used to receiving such strong signals from the heart, so it interprets them as pain in the chest and left arm
Clinical Features of Angina
Central, retrosternal chest pain Pain referred to the throat, jaw and teeth also to the armpits and often into the arm Frequently described as heaviness in the arms or chest Pallor
What is an Acute Myocardial Infarction
Death of an area of myocardium (infarction) Occurs when a coronary artery becomes occluded or significantly narrowed by a blood clot, embolism or vasospasm
Clinical Features of Acute MI
Rapid onset of severe central (retrosternal) chest pain, often described as crushing in nature May radiate to the neck, jaw, arms or back. Nausea and vomiting Faintness Feeling of impending doom Diaphoresis Rapid, shallow respirations Pallor / Grey Changes in vital signs 15 - 20% of patient’s may experience no chest pain Pain tends to last for more than 15 – 20 minutes
What is Heart Failure
Inability of the heart to pump adequately Left and right sides of the heart can fail separately or simultaneously Left heart failure (LVF) may accompany AMI and present as severe dyspnoea caused by pulmonary oedema
Heart Failure usually starts on which side
Right sided failure usually secondary to left sided failure. Results in fluid retention in the peripheral circulation (Congestive heart failure)
Clinical Signs of heart Failure
Laboured or difficult breathing (dyspnoea) Severe respiratory distress when the patient lies flat (orthopnoea) Ankle oedema Cyanosis Restlessness & agitation Confusion Elevated BP (Sympathetic response causes vasoconstriction) Wheeze Diaphoresis
Management of Acute Coronary Syndromes
ABCD approach
Ensure a defibrillator is immediately available
Reduce the workload of the heart
Aspirin 300 mg orally (crush/chew)
Nitroglycerine (GTN spray or tablet
Consider O2 therapy and/or Entonox
Assess pain score prior to and following pain relief
Monitor vital signs
12 lead ECG
Request Paramedic assistance for IV access and administration of morphine
Paramedic Management numonic
Morphine Oxygen Nitrates Aspirin