Cardiovascular Emergencies and Management Flashcards
(23 cards)
Common terms?
Atheroma- fatty calcified deposits
Arteriosclerosis - Hardening of the arteries
Artherosclerosis - scaring and fatty calcified deposits reduces blood flow and hardened arteries.
Atherosclerosis?
Slow progressive disease that affects blood vessels. If the outer layer cracks, the inner material triggers clot formation, further narrowing or blocking the artery.
Acute coronary syndrome?
Unstable angina and crescendo
NSTEMI
STEMI
Angina pectoris?
Temporary lack of oxygen to myocardial tissues due in times of increased myocardial oxygen demand. Increased C02 and lactic acid in the myocardium.
Stable Angina?
Occurs in a regular pattern, provoked by exertion or emotion to produce pain of predictable intensity, duration and location.Caused by a stable lesion in one of the arteries. self resolving or treated with rest 2-3 minutes.
Unstable angina?
Significant acute coronary syndrome.
Indicates an obstruction that is less stable and that a thrombus may be beginning to form
Angina presentation?
Pain behind the sternum, spreading across the chest.
Pain referred to neck, jaw, throat
Heaviness in chest or arms
Pale and sweaty (diaphoresis)
Provoked by exertion or emotion
Myocardial Infarction?
Process causing the death or damage to an area of myocardium as a result of coronary artery occlusion due to a thrombus.
Silent MI?
pulmonary oedema
Palpitations
Confusion
Hypotension
DKA
Syncope or pre syncope
MI presentation?
Severe central chest pain radiates to the neck, jaw, arms.
Crushing
Pallor, diaphoresis, nausea, vomiting
Sense of impending doom
Levines sign - clenched fist of chest
MI Management
Full set of observations including 12 lead ECG
Asprin 300mg
BP and pain score before GTN
GTN 400-800mcg
BP and pain score before GTN
Morphine - titrate 2.5mg
Consider ondansetron if patient is sick from the opioid.
What is heart failure?
A condition resulting from the heart becoming an incompetent pump. Result in myocardiis, chronic hypertension, cardiomyopathy. This causes problems with excessive fluid accumulation both in the pulmonary tissues and in the peripheries.
LHF is more common.
Congestive heart failure?
Inability of the heart to supply adequate blood flow and oxygen to peripheral tissues and organs.
LVF?
Left ventricle can not pump out enough blood
Pressure builds behind left side of heart
Pulmonary vessels become engorged with blood.
Fluid collects in lungs
LVF signs and symptoms
Dyspnoea
Tachypnoea
Tachycardia
Cyanosis
Orthopnoea
Hypoxia
Anxiety
Diaphoresis
RVF?
Blood backs up in the right ventricle and systemic veins
Cor Pulmonale - enlargement of R side of the heart.
RVF signs and symptoms?
Distended neck veins
Tachycardia
Systemic oedema
Swollen abdomen
Liver discomfort
Aortic Aneurysm
A dilation of the large blood vessel the aorta.
If it tears or ruptures it can be fatal.
Thoracic aortic aneurism
can occur in the ascending aorta the aortic arch and the descending thoracic aorta.
Abdominal Aortic Aneurism
Located along the section of the aorta that passes through the abdomen
Aortic Aneurism Presentation
Back or abdominal pain or vibrating feeling in chest or belly
If ruptured can present with dizziness, pallor, diaphoresis tachycardia, breathlessness, altered level of consciousness.
Cardiovascular assessment
SCENE SAFETY
ABCs - appearance
Well/ill/distressed
Alert/confused
Thin/obese
Colour: pallor/anaemia - pale skin
Cysnosis/shock
SOB
Oedema
Obvious abnormalities:
Marfan syndrome: disseting aneurysm of ascending aorta, inocompetent mitral valve
Dowens syndrome - congenital heart defect, VSD
Turners syndrome - coarctation of the aorta.
Cardiovascular Assessment
Full history takes
General inspection:
Inspect for clinical signs such as central and peripheral cyanosis, tar staining, assess bilateral BP and bilateral radial pulse
Inspect for scars, chest wall deformities, pulsations.
