S/S of inadequate central perfusion (4)
- Dyspnea
- Dizziness
- Syncope
- Chest pain
S/S of decreased CO (6)
- Hypotension
- Tachycardia
- Diaphoresis
- Anxiety
- Decreased cognition
- Dysrhythmias
S/S of decreased peripheral perfusion (4)
- Decreased hair distribution
- Non-localized/diffuse pain
- Coolness/pallor
- Cyanosis of extremities
Acute Coronary Syndrome (ACS)
Patients either have unstable angina or an acute MI
Angina
Chest pain caused by temporary imbalance of coronary arteries ability to supply oxygen and cardiac muscle’s demand for oxygen
Unstable angina
Chest pain/discomfort at rest/exertion that lasts longer than 15 minutes and is poorly controlled with nitro
Coronary Artery Disease (CAD)
Narrowing of the coronary arteries caused by build-up of fatty material in the walls of the arteries
How is CAD treated?
Coronary Artery Bypass Graft (CABG)
CABG Procedure
Large incision is made in chest by cutting sternum in half lengthwise and spreading it apart –> heart is stopped and tubes inserted into heart so blood can be pumped while heart isn’t beating
P wave
- First deflection
- Upright = positive
- Indicates atrial depolarization
PR interval
Depolarization and contraction of atria
QRS complex
- Follows P wave
- Downward deflection –> upward deflection –> downward deflection
- Ventricular depolarization (systole)
ST segment
- Occurs after ventricular depolarization has ended and before rMepolarization (diastole)
T wave
- Modest upward waveform
- Represent ventricular repolarization
MONA
Morphine
Oxygen
Nitro
Aspirin
Shockable rhythms
- V-tach
- V-fib
Nonshockable rhythms
- Asystole
- PEA
Ventricular tachycardia
- Rhythm: regular/irregular
- Heart rate: 150-250/minute
- P wave: seldom seen
- PR interval: not measurable
- QRS interval: wide, distorted
Symptoms: palpitations, lightheaded, syncope
Ventricular fibrillation
- Rhythm: irregular/chaotic
- HR: not measurable
- P wave: not visible
- PR interval: not measurable
- QRS interval: not measurable
- Fatal if not treated in 3-5 minutes
- S/S: pulseless, no breathing
1st Degree AV Block
- Conduction delayed through AV node
- PR interval >0.2 seconds
Risk factors for 1st degree AV block
- Older age
- MI
- CAD
- Rheumatic fever
- Hyperthyroidism
- Electrolyte imbalances
- Beta blockers
- Calcium channel blockers
2nd degree AV block type 1
- PR interval
Risk factors for type 1 2nd degree AV block
- Digoxin
- Beta blockers
- CAD
- Inferior MI
Treatment for type 1 2nd degree AV blocks
- Symptomatic = temp. pacemaker
- Unsymptoamtic = observation
