Acute Coronary Syndrome (ACS)

09/02/2010

a set of signs and symptoms related to decreased blood flow to the heart. ACS is compatible with a diagnosis of acute myocardial ischemia, but it is not pathonomonic.

Manifestations

  • chest pain
  • tightness around the chest and radiating to the left arm and the left angle of the jaw.
  • may be associated with diaphoresis
  • nausea
  • vomiting
  • shortness of breath.
  •  Some may report palpitations
  • feeling of anxiety
  • sense of impending doom

Diagnosis of MI:

  • ECG
  • Blood tests – troponin marker levels


The Universal Fatigue Assessment Scale

06/10/2009


Congestive Heart Failure (CHF)

02/10/2009

 

The heart does not pump with enough force or pump a large enough volume of blood to adequately perfuse the tissues and the organs of the body. This results in a black log of fluid pooling in the lungs and other tissues of the body.

 

Etiology

 

  • chronic poor blood flow to the heart (may or may not be accompanied by angina)

  • heart muscle damage from previous heart attack

  • high blood pressure

  • heart valve disease

  • cardiopathology infection of the heart

  • excessive use of alcohol or drugs

  • Idopathologic cardiopathology

 

Signs and Symptoms

 

  • Shortness of breath (SOB)

  • Swollen ankles or legs

  • Sudden weight gain

  • Tiredness or loss of energy

  • Sudden loss or change in appetite

 

Tx/Management

 

  • fluid restriction

  • limit alcohol intake or abstain

  • medications

  • diet/ behavior modification

  • low levels of physical activity (walking, swimming) – increase muscle fitness, no strenuous excercise

 

  • symptom control

  • preventing disease progression

  • goal to prevent development of acute decompensated heart failure (ADHF) (causes respiratory distress)

 

medications:

 

 

 

 

Bedard, Dale, Hoeschen, R, J, Klassen, Linda, Kertland, H, Savage, Marlene, and Tam, J. 2006. Congestive Heart Failure. Heart and Stroke Foundation.

Bloomington Hospital. CHF. Retrieved October 2, 2009 from http://www.bloomingtonhospital.org/oth/Page.asp?PageID=OTH001027


Atrial fibrillation

04/09/2009

Atrial fibrillation causes a rapid, disorganized and uncoordinated twitching of atrial musculature.

It is the most common dysrhythmia to cause for patients so seek medical attention.

It may start and stop suddenly.

It may occur for a very short time period of time (paroxymal) or may be chronic.

Etiology:

  • advanced age
  • valvular disease
  • coronary artery disease
  • hypertension
  • cardiopathy (disease of the heart muscle)
  • hyperthyroidism
  • pulmonary disease
  • acute moderate to heavy ingestion of alcohol (holiday heart syndrome)
  • aftermath of open heart surgery
  • May also occur in individuals with no underlying pathophysiology

Physiology/Biology:

Rapid atrial response reduces time for ventricular filling. This results in a smaller stroke volume.

This rhythm causes the atria and ventricle to contract at different times, the atrial kick (the last part of diastole and ventricular filling, which accounts for 25% to 30% of the cardiac output) is also lost.

Symptoms:

  • irregular palpitations
  • fatigue
  • malaise

Treatment:

Depends on cause, duration of symptoms, and comorbidities. Medications may be used to stabilize heart rhythum or prevent recurrence of fibrillations.

In many cases atrial firillation converts to sinus rhythum with in 24 hours without treatment.

 

Bare, Brenda, Day, Rene, A, Paul, Pauline, Smeltzer, Suzanne, C, and Williams, Bev. 2007. Textbook of Medical-Surgical Nursing. 1st Candaian ed. Lippincott Williams & Wilkins, Philadelphia. p. 695-696


Electromechanical dissociation (Pulseless Electrical Activity)

29/08/2009

 

Electromechanical dissociation, Non-Perfusing Rhythm or  Pulseless Electrical Activity is a cardiac condition whereby the electrocardiogram is showing a heart rhythm that should be producing a pulse, however does not.

Etiology:

Hypovolemia – a state of decreased blood volume.

Electromechanical dissociation. Retrieved August 29, 2009 from http://apma-nc.com/PatientEducation/electromechanical_dissociation.htm


Cardiac (Pericardial) Tamponade

25/08/2009

Cardiac tamponade results when the heart is compressed by an abnormal accumulation of fluid in the pericardium, the membranous sac enclosing the heart. Significant increase in pressure on the heart due to dramatically elevated fluid levels will impede the hearts ventricles from properly filling with blood. This will decrease cardiac output resulting in a lower volume of oxygenated blood being delivered to the body`s tissues.

Cardiac tamponade in a newborn with respiratory distress syndrome who developed pneumopericardium associated with barotrauma from mechanical ventilation. Chest radiograph shows pneumopericardium with cardiac tamponade.

 

 

 

Jauhar, Sandeep. 2008. Intern : a doctor’s initiation. Farrar, Straus and Giroux, New York.