acute coronary death;asystole;fibrillaiton

Question 1

definition

Answer 1

• Acute coronary death due to changes of heart - ischaemic heart disease.
• Acute coronary death is within 6 hours of onset of symptoms without absolute reason.

Question 2

etiology

Answer 2

1. cardiac causes
   a. coronary- acute MI, chronic IHD, congenital anomality of coronary arteries
   b. non-coronary- hypertrophic cardiomyopathy, valvular heart disease, ventricular fibrillation.
2. extracardiac causes- asphyxia, hypoxia, hypercapnea, metabolic and electrolytes disorders, intoxication.

Question 3

signs and symptoms

Answer 3

• tachycardia, pacemaker everywhere, heart rate >300, ECG abnormality, dizziness, cardiac region pain.

Question 4

asystole

Answer 4

absent of cardiac systole and referred as death arrhythmias.
Asystole is a direct plane of ECG
Asystole occurs following termination of atrial, ventricular tachycardias. This pause is usually insignificant. Asystole of longer duration in the presence of acute MI and CAD is fatal.

Question 5

asystole : etiology

Answer 5

• changes of pacemaker, MI near SA node, deep ischemia, recurrent MI, thrombosis of main left coronary artery.

Question 6

clinical pictures

Answer 6

• loss of consciousness, pale skin, absent of heart rate, BP, pulse

Question 7

asystole : treatment

bad prognosis

Answer 7

i) Antiarrythmic drugs- lidocaine
ii) Defibrillation therapy
iii) Direct or indirect cardiac massage.
- CPR, 100% oxygen, IV infusion, intubation
- epinephrine 1.0 mg., IV push, q3-5 minutes, atropine

Question 8

fibrillation

Answer 8

• fibrilatory changes of cardia due to ischemic process.
• Ventricular fibrillation is very rapid & irregular ventricular activation.

Question 9

fibrillation : clinical picture

Answer 9

Clinical picture: no pulse, unconscious, respiration ceases (cardiac arrest)

Question 10

mechanism

Answer 10

• acute ischemic changes due to spasm or thrombosis. lead to alteration of Na-K ATPase activity and cause leakage of K. and increase excitability.
• It cause non specific irritation and tachyarrythmias which lead to ventricular fibrillation

Question 11

fibrillation : clinical picture

Answer 11

• loss of consciousness, pale skin, absent pulse, decrease Bp and heart rate, apex beat absent.
• ECG- wide and deformed T, low complexes and irregular R-R intervals.

1. sudden development
2. within 15 seconds, patient in laying position
3. in 40 seconds, 1 time muscles contraction
4. in 1 min 30 seconds, maximum dilatation of pupil
5. > 2 mins, rhythm stop, coronary death, heart stop pumping, but patient still breathing (clinical death)