Cardiac Diseases (1 or 2)

Question 1

Chest Pain/Myocardial Infarction (Treatment/Management)

Answer 1

1) Immediate oxygen therapy at 100%
2) Closely monitor vital signs

3) Drug therapy
- atropine for bradycardia
- defibrillate for pulseless ventricular tachycardia/fibrillation
- nitrates for chest pain
- aspirin, anti-arrhythmic agents

Question 2

Congestive Heart Failure/Pulmonary Edema

Answer 2

1) Immediate oxygen therapy at 100%
2) Closely monitor vital signs
3) IPPB w/ 100% oxygen

4) Drug therapy
- diuretics: to promote fluid excretion
* furosemide (Lasix)
* bumex
* aldactone

• positive inotropic agents
• digitalis
• digoxin
• dopamine
• low dose amiodarone
• analgesic/sedative
• morphine
• afterload reduction agents
• morphine
• nitroglycerin
• nitorprusside
• ACE inhibitors
• electrolyte replacement
• potassium
• sodium

5) mechanical ventilation w/ PEEP for ventilatory failure

Question 3

Arrhythmias (Treatment/Management)

Answer 3

Treatment depends on type & cause of arrhythmia

1) Premature Ventricular Contraction (PVC)
- Treat w/ oxygen & consider causes

2) Ventricular fibrillation & pulseless ventricular tachycardia
- defibrillate at 360 joules

3) Atrial flutter, fibrillation & ventricular tachycardia w/ a pulse are not immediately life threatening
- perform synchronized cardioversion starting at 50-100 joules

4) Drug therapy
- anti-arrhythmic agents

Question 4

Shock (Treatment/Management)

Answer 4

1) Mechanical ventilation for ventilatory failure

2) Drug therapy
- vasopressors for vasogenic hypovolemia
- digitalis, digoxin for heart failure
- antibiotics for infection

3) Treat hypovolemia
- IV fluids
- blood transfusion

Question 5

Cor Pulmonale (Treatment/Management)

Answer 5

1) Oxygen therapy
2) Closely monitor vital signs
3) Treat underlying cause
4) Decrease workload of the right ventricle by lowering pulmonary artery pressure

5) Drug therapy
- digitalis
- diuretics
- pulmonary vasodilators (nitric oxide)