Treatment
IV heparin
prolongs clotting time, prevents formation of clots by inactivating factors IIa and XIa
Tachycardia
sympathetic activation from decreased CO
2+ peripheral edema progression signified
progression to right heart failure
Dopamine
Depends: dopamine (<3) beta receptors (3-10) alpha (>10)
Vasodilator for visceral, vasoconstrictor peripherally
lack of wall movement
Akinetic walls
Crackles
Pulmonary edema - diastolic dysfunction from ischemia causes backup
Contraindicated for uncorrected ventricular tachycardia or ventricular fibrillation
Dopamine
apex movement outward during systole
dyskinetic apex
No DP or PT pulses
peripheral vasoconstriction from sympathetic activation + decreased CO
Which pap muscle usually involved in post-MI rupture?
Posteromedial.... why?
Furosemide
Loop diuretic - decreases plasma volume and preload
high anion gap
lactic acidosis caused by organ hypoperfusion - anaerobic respiration
S3
commonly seen in acute heart failure, associated with high LA pressure and high LVEDP
Hyperkalemia
K+ release from ischemic cells, Na-K pump dysfunction
IABP
decreases afterload and myocardial oxygen demand
Ventricular Tachycardia
myocardial ischemia causes K+ release from ischemic cells, which partially depolarizes surrounding cells and may cause spontaneous activity
S4
Acute diastolic heart failure - LV wall ischemia causes decreased wall motion
BUN:creatinine ratio >20:1
pre-renal AKI