Terms to know Ischemia Infarction Atherosclerosis - - PowerPoint PPT Presentation

Terms to know

• Ischemia
• Infarction
• Atherosclerosis
• Thromboembolism
• Angina Pectoris
• Acute Myocardial Infarction

(AMI)

• Pacemaker/Defibrillator

Ischemia

• “Decreased blood flow” In this case, to the heart muscle.
• Causes can be partial or complete blockage of blood flow

through coronary arteries.

• The tissues soon begin to starve and eventually die if

blood flow is not restored.

• Ischemic Heart Disease – disease causing decrease in

blood flow to heart muscle.

Infarction

• “Death of tissue”
• If ischemia is not corrected and blood flow restored to the

muscle than the tissues begin to die.

• Death of the heart muscle causes diminished ability to

pump and if significant portion of the muscle is affected

Atherosclerosis

• Disorder in which calcium and

fatty material called cholesterol build up and form a plaque inside the walls of blood vessels.

• Can cause partial or complete

blockage of coronary arteries.

Thromboembolism

Pacemaker/Defibrillator

• Can be just pacemaker, or just defibrillator, or both.
• Single or dual chamber
• Atrial vs. ventricular
• Can be demand or

constant.

What is Acute Coronary Syndrome?

• “A group of symptoms caused by myocardial ischemia”
• Chest pain usually caused by either angina pectoris or

Acute Myocardial Infarction

• Treat as if it is “worst case scenario”
• Symptoms vary!

Angina pectoris

• “Angina”
• Can be caused by a spasm of the coronary artery
• Usually it is a symptom atherosclerotic coronary artery

disease but is brief and resolves.

• It is a symptom of the heart muscle needing more oxygen

and usually occurs during periods of physical or emotional stress.

• Usually goes away if the stressor is stopped.

Acute Myocardial Infarction

• HEART ATTACK
• Blockage in a coronary artery
• Infarction – “Death” Myocardial – Heart muscle
• Serious consequences
• Sudden death
• Cardiogenic shock
• Congestive heart failure

Acute Myocardial Infarction

AMI continued

• Signs/Symptoms
• Anxiety/confusion/agitation
• Weakness
• Nausea/vomiting
• Sweating/pale or ashen
• Slow or fast heart rate (depends on area of the heart affected)
• Pain –”Crushing”
• chest, back, neck, jaw, OR arms
• Shortness of breath

Symptoms of AMI

• Sudden onset of weakness, nausea and sweating without obvious

cause

• Chest pain, discomfort or pressure. “Crushing” “squeezing”
• Other pain – jaw, back, neck, abdomen.
• Irregular heart beat
• Syncope
• Shortness of breath
• Nausea/vomiting
• Sudden death

Assessment

• Initial impression
• Airway, breathing, circulation
• Immediate life threats
• VS
• HR, BP, RR, SpO2,
• History
• SAMPLE/OPQRST
• Medication List/allergies
• Remember that symptoms can be very atypical and don’t always

include chest pain.

History taking

SAMPLE

• Signs/symptoms
• Allergies
• Medications
• Past medical History
• Last oral intake
• Events leading up to event

OPQRST

• Onset
• Provocation
• Quality
• Radiation
• Severity
• Time

Treatment

• Stabilize life threats (Airway, Breathing, Circulation)
• Oxygen
• Transport early if possible!
• They need ALS care including EKG as soon as possible
• Possibly assist with patient’s medications
• Nitroglycerin

Other Causes of Chest Pain or Cardiac- like symptoms

• Thoracic Aortic Aneurysm – weakened area of the aorta

which may expand due to the pressure of the aorta and can even rupture.

• Pulmonary Embolism – if that thromboembolism does go

to the heart it might go to the lungs!

• Anxiety/hyperventilation – causes muscle tightness and

feeling of shortness of breath/chest pain.

• Gastric issues (reflux, “heartburn”) – Can be felt in the

chest, although it is a gastric problem.