Coronary Heart Disease
involves formation of plaque inside the arterial wall
atherosclerosis
inadequate blood flow to the heart
Ischemia
Treatment for chest pain (1-4)
ONAM (oxygen, nitro, aspirin, morphine)
when the heart fails to generate or conduct its own stimulus we put this in
can be temporary or permanent
Pacemaker
most frequent complication of MI
heart being deprived of O2, tissue is dead
Dysrhythmias
constricts arteries limiting flow, reduces HDL levels, increases platelet
Nicotine: smoking is the biggest risk factor
death of portion of heart
Infarction
indigestion, burning, nausea, palpitations (females think its just GI issues)
Atypical Symptoms of AMI
Noninvasive temporary pacing
large gelled electrode pads placed anterior & posterior then connected to external pulse generator
External Pacemaker
can be done with just the generator
type of heart failure
impaired ability of the heart to pump
heart unable to meet body's demands & maintain organ function
Cardiogenic Shock
EKG, echocardiogram, exercise stress test, thallium exercise stress test, angiogram, labs
diagnostics of coronary artery disease
clinical manifestation of infarction
angina
Diagnostic test that indicates MI or recently having one
Troponins: CTT & cTI
temporary (hours to weeks)
electrodes attach to epicardium of the atrium & ventricles
wires brought out through chest wall to external generator
Invasive temporary pacemaker
inflammation of pericardium
squeezes and constricts heart
pericarditis
Lipid management: cholesterol below: ____, LDL level: ____, HDL level: ____, triglycerides: ____
cholesterol: <200, LDL: <100, HDL: >60, triglycerides: <150
HDL= "good cholesterol"
pain with increasing frequency, last longer and more severe
occurs at rest or low levels activity
requires urgent in-hospital management
Unstable angina (pre-infarction angina)
If it lasts longer than 15 minutes call ambulance or go to ER
dissolve clots and reperfuse artery
given in first 6 hrs of MI onset
IV bolus over 2-5 minutes
Thrombolytics
limit mobility of affected side
need medical alert bracelet
limit mobility for 48 hours after procedure
Permanent Pacemaker
abnormal collection of fluid between pericardial layers manifestations depends on rate of accumulation
Pericardial Effusion
Diet: low cholesterol & ___ fats, fat calories ____% of total caloric intake, ___g of soluble fiber a day
saturated fats, <30%, 25g
Medications to treat myocardial Ischemia
Nitrates, Asprin, beta blockers, Ca++ channel blockers
Used to restore blood flow & O2 to ischemic myocardium
PTCA (Percutaneous Transluminal Coronary Angioplasty
CABG (Coronary Artery Bypass Graft
When monitoring heart rate for someone with a temporary pacemaker you should
compare to the set rate, it should always be at the set rate or above NEVER BELOW
Medical Emergency
when compression occurs (from pericardial effusion)
Cardiac Tamponade