Cardiac Note Jan 25

8 SUDDEN CARDIAC DEATH 857 854 Lewis Med Surg. BOOK CH 37 P 759 SUDDEN CARDIAC DEATH 857 APPENDIXIA-AGLS P. 1732 856 Lewis Med Surg. BOOK CH 37 P855 10 CARDIAC TAMPONADE 413 412 Lewis Med Surg BOOK CH 40 p. 910 11. SIGNS OF CARDIAC TAMPONADE Lewis Med Surg BOOK CH 40 P 904-919 12. INFLAMMATORY HEART DISORDERS 411 912 410 Lewis Med Surg BOOK CH 40 p. 909 EFFUSION VS. (13) PERICARDIAL TAMPONAD Lewis Med SURG BOOK CH 40 p. 909-95 14 STEMI NSTEMI 844 843 842 Low's Med Surg BOOK CH 37 p. 841 15 ACUTE CORONARY SYNDROME 850-859 SUDDEN CARDIAC DEATH PRIORITY IS TAKE ACTION CLINICAL PRESENTATIONS: SUDDEN COLLAPSE UNRESPONSIVE ! L. PREVENT NEUROLOGICAL DAMAGE RESTORATION OF CIRCULATION PULSELESS IMMEDIATE OPR RESUSCITATION EVALVATION CPR/OR DEFIBRILATION UNTIL RETURN L OF SPONTANEOUS CIRCULATION WITH GSINUS RHYTHM OR IMPROVEMENT ON ECG IMPROVING BLOOD PRESSURE ACCUMULATION OF FLUID IN PERICARDIAL SAC COMPRESSING THE HEART AND IMPAIRING VENTRICULAR FILLING REDUCES CARDIAC OUTPUT THIS CREATES OBSTRUCTIVE SHOCK & SEVERE COMPERMISE ON THE HEMODYNAMIC SYSTEM SIGNS OF CARDIAC TAMPONADE HYPOTENSION *IVEULAR VENOUS DISTENSION * MUFFLED HEART SOUNDS * PULSUS PARADOXUS MEDICAL EMERGENCY #1 PREPARATION FOR PERICARDIOCENTESIS REMOVAL OF FLUID COMPRESSING THE HEART PERICARDIAL EFFUSION IS THE ACCUMULATION OF FWID IN THE PERICARDIAL SAC WITHOUT COMPERMISING THE HEART HEMODYNAMICS THIS CAN LEAD TO TAMPONADE IF UNMANAGED CARDIAC TAMPONADE WILL CAUSE A DECREASE IN CARDIAC OUTPUT LEADING TO SHOCK STEMI COMPLETE OCCLUSION OF CORONARY ARTERY WITH ST ELEVATION ELEVATED TROPONINS NSTEMI PARTIAL OCCLUSION OF CORONARY ARTERY WITHOUT ST *ELEVATED TROPONINS ELEVATION ACUTE CORONARY SYNDROME: REDUCE INFARCT SIZE & SEVERITY RAPID ASSESSMENTS SUPPLEMENTAL O2 ECG CARDIAC MONITORING EVALUATION OF REPERFUSION Lewis Med SURG BOOK CH 37 P 849 16 ACS. DIAGNOSTICS 743 842 LOW'S Med SURG BOOK СН 37 р. 840 17 RHYTHMS IDENTIFICATION 899 Lewis Med Surg BOOK CH 34 P 884 18. HEART BLOCKS 885 LOWIS Med Surg. BOOK CH 34 p. 884 (19) MANAGING DYSRHYTHMIAS 901 900 Lewis Med Surg BOOK CH 34 p. 899 20 RHYTHM S CARDIAC ARREST LOW's Med Surg. BOOK CH 34 p. 884 21 ELECTRICAL THERAPIES LEWIS Med SURG BOOK CH 39 p. 849-965 ELEVATED TROPONINS CONFIRMATION OF MYOCARDIAL INJURY ECG CHANGES LOCALIZE ISCHEMIA OR INFARCTION (LEADS) LONCOING MONITORING TO GUIDE ACTIONS IN REAL TIME IDENTIFICATION OF ASSESSMENT OF RATE & REGULARITY RHYTHMS *P WAVES PRESENT? + MEASURE PR INTERVAL * ANALYZE ORS COMPLEX ABNORMALITIES IN RHYTHMS ASSESS ELECTROLYTES ELECTRICAL CODUCTION ISSUES 1ST DEGREE HEART BLOCK DELAYLD CONDUCTION: PR>0.20 SEC 2ND DEGREE BLOCK TYPE 1 PROGRESSIVE PROLONGATION OF PR UNTIL ORS TYPE 2 CONSTANT PR INTERVAL IS DROPPED 3RD DEGREE BLOCK COMPLETE DISRUPTION OF AV CONDUCTION STABLE DYSRHYTHMIAS L MEDICATIONS * PALPATATIONS * SINUS TACH SINUS BRADY PREMATURE VENTRICULAR CONTRACTIONS UNSTABLE RHYTHMS SYN. CARDIOVERSION DEFIBRILATION PACING VENTRICULAR TACH. FIB COMPLETE BLOCK *ASYSTOLE/PEA CPR, MEDICATIONS (VFIB) VENTRICULAR FIBRILATION PULSELESS VTACH 3 SHOCKABLE } DEFIBRILATION SHOCK DELIVERED TO PULSELLSS RHYTHMS SYNC CARDIOVERSION UNSTABLE TACHYARRYTHMINS WITH A PULSE TO PREVENT INDUCING VENTRICULAR FIB. UNSYNCRONIZED CARDIOVERSION- (22) PACEMAKERS ICD'S Lewis Med Surg BOOK CH 39 p. 899 900 PACEMAKERS TREAT BRADYCARDIA HEART BLOCKS ICDS TERMINATE VENTRICULAR TACHY ARRHYTHMIAS PACING SPIKES APPEAR BEFORE ATRIAL/VENTRICULAR DEPOLARIZATION