CHF
Which is the most common type of heart failure?
Left sided or Right sided
Left sided
What does SVT stand for? and what is it?
Supraventricular Tachycardia
Abnormally fast heart beat. Generally greater then 160 BPM.
Potential triggers of AFIB?
Binge drinking, hypertension, atherosclerosis, obesity, excessive caffeine, illegal drugs, smoking
What does STEMI vs NSTEMI cause on the cardiac monitor?
STEMI-ST-segment elevation MI
NSTEMI-ST-segment depressions and inverted T waves
This type of heart failure causes the blood to back up in the lungs causing SOB, weakness and dizziness.
Left-sided CHF
Causes of SVT? Name 4
Excessive caffeine, alcohol, smoking, heart attack, mitral valve disease
What is AFIB?
Upper chambers (atria) beat chaotically and irregularly out of sync with the lower chambers (ventricles).
What are sign and symptoms of STEMI/NSTEMI? Name 4
Chest pain-described as heaviness or pressure lasting more than 20 minutes and during rest
Pain radiating to the left arm, left shoulder, neck and jaw
Diaphoresis, nausea, vomiting, dyspnea, palpitations, syncope,
Women and elderly patients may experience atypical symptoms-dyspnea, indigestion
This type of heart failure causes the blood to back up in the veins causing leg, ankle and belly swelling.
Right-sided Heart Failure
What are some potential symptoms of SVT? Name 4
Chest discomfort, SOB, fatigue, lightheadedness, dizziness, pulsations in the neck, palpitations, chest pain, Nausea
AFIB symptoms-name 3
SOB, weakness, heart palpitations, chest pain, dizziness, lightheadedness, fatigue, reduced ability to exercise.
What labs would you check if you think your patient has had a cardiac episode?
Troponin-only released when myocardial necrosis occurs
CBC-could have elevated WBC count due to proinflammatory state, presence of anemia and platelet count must be checked before thrombolytic agent administered (STEMI)
CMP-Potassium and magnesium levels must be checked due to the potential for fatal cardiac dysrhythmias in MI patients, creatinine levels are checked for potential cardiac cath or ACE inhibitor administration
Fasting lipid profile
1.What usually causes Left-sided heart failure?
2.What usually causes right sided heart failure?
1. Coronary artery disease
2. Left sided heart failure
What option for short term treatment should be initiated first to see if it works before initiating other more invasive options?
Maneuvers are usually the first treatment unless you have severe symptoms. These attempt to activate a nerve called the vagus nerve. Activating this nerve can cause a brief slowing of your heartbeat in attempt to break the abnormal circuit. Valsalva maneuver (you bear down with your stomach muscles, as though you were trying to have a bowel movement). The provider might also try massaging the carotid artery in your neck, having you blow in a straw, or cough hard.
What are some risk factors for AFIB? Name at least 3
Age, heart disease, hypertension, thyroid disease, alcohol, obesity, genetics, chronic conditions-diabetes, kidney disease, lung disease, sleep apnea
What would standard medical treatment be? Name 4
Oxygen therapy if appropriate
Nitrate administration if appropriate
Analgesic therapy with morphine
Beta blocker within 24 hours
Antiplatelet therapy
Statin therapy
What are some expected treatments for CHF? Name at least 2
Diuretics, vasodilators, Beta-blockers, digoxin, pulmonary vasodilators.
What is a potential long term treatment of SVT?
Beta-blockers or calcium channel blockers and/orCatheter ablation
What are some meds that are used to treat AFIB? Name at least 6
Blood thinners-Eliquis, aspirin, pradaxa, lovenox, heparin, xeralto, coumadin.
Heart rate meds-Atenolol, coreg, lopressor, inderal.
Calcium channel blockers-Cardizem, verapamil.
Sodium channel blockers-Tambocor, rythmol, quindine
Potassium channel blockers- Amiodarone, dofetilide, sotalol
How would you treat a STEMI vs NSTEMI?
STEMI-Primary PCI (Angioplasty with stenting), Urgent CABG
NSTEMI-Primary PCI (Angioplasty with stenting), CABG