Medical Emergencies - Cardiac Emergencies

What terms relate to chest pain

artherosclerosis, coronary artery disease

What is artherosclerosis

hardening/thickening of the arteries

What is coronary artery disease

artherosclerosis of the coronary arteries

coronary artery disease is the most common cause of

myocardial ischemia

what is myocardial ischemia

inadequate blood/oxygen to heart muscle

What are the two types of predisposing factors of coronary artery disease

non-modifiable and modifiable factors

what are examples of non-modifiable factors of coronary artery disease

Gender, age, heredity

what are examples of modifiable factors of coronary artery disease

smoking, hypertension, high cholesterol, diabetes, obesity and physical activity

what is angina pectoris

severe pain in and around heart

what causes angina pectoris

insufficient supply of oxygenated blood

what are predisposing factors of angina pectoris

Physical exertion, emotional stress, cold food and drinks, dressing, bathing, disturbing dreams, large meals, smog, high altitudes

prevention of angina pectoris can be through taking a _____ and

thorough medical history, medications, monitoring vitals, keeping stress and anxiety down, using oxygen tanks as needed

what are the medications that can prevent angina pectoris

nitroglycerin and amyl nitrate

nitroglycerin is a _____ for relief of angina pectoris

coronary vasodilator

nitroglycerin is usually placed _____ and is quick acting~ usually __ minutes

under the tongue, 2-4

amyl nitrate is used for angina pectoris and is a _____ which relaxes the ______ of the coronary arteries

vasodilator, smooth muscle

amyl nitrate can be found in _____, but is usually a second choice because

some emergency kits, it may decrease blood pressure

if SpO2 is below ___ for someone with angina pectoris, you can administer oxygen

92%

what are the signs and symptoms of angina pectoris

- substernal chest discomfort lasting 1-15 minutes

- levine sign

- apprehension

- paleness

- increased pulse

- increase BP

what is the Levine sign

pressing fist to sternum

an acute myocardial infarction can also be called a

heart attack

what is an acute myocardial infarction (heart attack)

necrosis of a portion of the myocardium due to total or partial occlusion of a coronary artery

what are the predisposing factors of acute myocardial infarction

coronary artery disease, heredity, age, hypertension, high cholesterol, obesity, stress

what is the biggest predisposing factor of acute myocardial infarction

coronary artery disease

what are ways to prevent acute myocardial infarction

- thorough medical history

- medications

- take good vitals

- reduce stress for patients

what are the signs and symptoms of acute myocardial infarction

- chest pain/ discomfort lasting 20 minutes or longer

- pain radiating down arm and shoulder and in neck, jaw, and back

- levine sign

- nausea and vomiting

- profuse sweating

- feeling of impending doom

- pain not relieved by nitroglycerin

what is the big sign and symptom of acute myocardial infarction

profuse sweating

for management of patients experiencing chest pain, during the evaluate step if patient has no history of angina, what should you do

activate code blue immediately

for management of patients experiencing chest pain, during the evaluate step if patient has history of angina, what should you do

administer nitroglycerin

how should you position the patient if they are experiencing chest pain

semi-upright or upright

what is the treatment for a heart attack (during implement appropriate action step)

1. chew 4 (81mg) aspirin

2. administer oxygen only if patient has dyspnea (labored breathing)

3. continue assessing patient and administer BLS and AED if needed

Many medications for treatment of cardiac conditions work as

diuretics

Many medications for treatment of cardiac conditions make patients prone to

xerostomia (dry mouth) and candidiasis (fungal infection of mouth)

what is heart failure

condition in which the heart muscle is damaged and can no longer pump sufficient amounts of oxygenated blood throughout body

what does heart failure cause

build-up of fluid/blood that may leak into lungs (pulmonary edema)

what is the cardinal symptom of heart failure

dyspnea (labored breathing)

what are the signs and symptoms of heart failure

dyspnea, pitting edema of legs and ankles as condition worsens

when treating patients with heart failure in the dental office be sure to take a _____, monitor ___, and you may need to administer ____

thorough medical history, vitals, oxygen

when treating patients with heart failure in the dental office you may need to place patient in ___ or ____ position during treatment

upright, semi-upright

what is acute pulmonary edema

swift and abrupt accumulation of fluid in the alveolar spaces of lungs resulting in decreased ability of lungs to oxygenate the blood

what is the most life-threatening symptom of heart failure

acute pulmonary edema

what are the signs and symptoms of acute pulmonary edema

- labored breathing

- rapid pulse

- felling of suffocation

- acute sense of anxiety

- cyanotic lips and nail beds

- cough producing frothy, blood-tinged sputum

how should you position a patient for acute pulmonary edema

upright or semi-upright

if acute pulmonary edema is suspected what should you do

activate code blue immediately

what is pulmonary arrest

patient stops breathing

pulmonary arrest may progress to

full cardiac arrest

what is cardiac arrest

heart no longer sufficiently pumping blood, not beating

if a patient is in cardiac arrest, how should you position them

supine

if a patient is in cardiac arrest, what should you do

activate code blue immediately

what is a pacemaker

device composed of a pulse generator and leads that is implemented into the chest an provides pacing impulses to the heart when necessary

what is a defibrillator

similar to pacemaker but can provide defibrillation currents to heart

what can cause a pacemaker or defibrillator to malfunction temporarily

electromagnetic interference

what are considerations with certain dental equipment that can cause pacemaker or defibrillator to malfunction temporarily

- magnetostrictive ultrasonic scalers

- ultrasonic cleaning baths

- sonic toothbrushes with batter charger

what are sign and symptoms of pacemaker or defibrillator malfunction

- chest pain

- abnormal cardiac rhythms

- twitching

- other signs/symptoms associated with condition device is trying to treat

for the management of pacemaker or defibrillator malfunction, remove ______, check ___ and

all suspected causes of interference, vitals, continually monitor pulse rate to see that it returns to normal