Cardiac assessment

What is acute coronary syndrome?

Describes a range of conditions relating to reduced blood flow to the heart

What are the three acute coronary syndromes?

STEMI - ST elevated myocardial infarction

NSTEMI - non ST elevated myocardial infarction

Unstable angina

What are some visual signs of cardiac pain / issues?

Tripoding
Cyanosis
Clutching chest
Pale
Diaphoresis
Clubbing

Where else can cardiac pain also present?

Back
Abdomen
Shoulder

What can be presented by a sharp chest pain that isn’t cardiac?

Pulmonary embolism
Pneumonia
Pleurisy (inflamed plural cavity lungs - worse on inhalation)
Muscular- skeletal pain

What can be presented by a tearing / ripping chest pain?

Aortic dissection

What can be presented by a burning chest pain?

GORD (heartburn / acid reflux) - worse after eating
Peptic ulcers (stomach ulcers)

What can be presented by a aching / dull chest pain?

Muscular-skeletal
Inflammation

What are 4 associated symptoms of cardiac issues?

SOB
Nausea / vomiting
Diaphoresis
Off colour

What is the reasoning for SOB when experiencing cardiac issues?

Ventilation - perfusion mismatch so oxygen ins't being circulated properly

What is the reasoning for diaphoresis when experiencing cardiac issues?

clogged arteries means heart works harder, producing more heat

What is the reasoning for being cold and clammy when experiencing cardiac issues?

hormones cause peripheral vasoconstriction, decreasing blood supply to skin and increased sweating

On deep inhalation, if the pain worsens, does this indicate muscular or cardiac ?

Muscular as cardiac pain wouldn't be impacted

What would you inspect during a cardiac assessment?

Scars
Pacemakers
ICD (implanted defibulator)

What would you palpate during a cardiac assessment?

Strength rate and regularity of pulse

Intercostal muscles - if pain worsens on palpitation may be muscular

What would you percuss during a cardiac assessment?

If fluid in lungs due to heart failure

What would you auscultate during a cardiac assessment?

Heart sounds for heart murmur

What does a heart murmur sound like?

Whoosh or hum instead of lub-dub

How does pulmonary oedema occur?

Left ventricle doesn't work causing blood to back flow through the bicuspid valve into pulmonary circulation.

This increases pressure so fluid leaks out into interstitial space and enter the alveoli

What are two commonly used heart medications?

Asprin
GTN (Glyceryl trinitite)

What is aspirin used for ?

Anti coagulant for patients with ischaemia

What is GTN used for?

Vasodilator to ease pain of ischaemia and relive pressure

What is atherosclerosis?

Thickening or hardening of the arteries caused by a buildup of plaque in the inner lining

What is it called when an artery becomes thicker due to plaque build up?

Atherosclerosis

What is ischaemia?

Reduced blood flow and therefore oxygen to part of a tissue

What can mature plaque lead to?

Ruptured plaque and thrombosis ( blood clot in the blood vessels )