cardio

PRS Interval

Time it takes for an electrical impulse to travel from the atria to the ventricles(0.12-0.20)

Sinus Rhythm

Indicates good electrical conduction and adequate cardiac output! No intervention necessary UNLESS patient becomes symptomatic.

Arrythmia/Dysrhythmia

Abnormal heart rhythms that are either too slow/fast, which can impair perfusion, leading to complications.

Sinus Bradycardia

-Slow heart rhythm(<60 bpm), that can be caused by medications, ICP, athletic conditioning,etc
-Symptoms: Hypotension, dizziness, LOC changes
-Management: Hold heart-rate slowing meds(beta-blockers), Atropine, transcutaneous pacing if unstable

Sinus Tachycardia

-Fast heart rhythm(>100 bpm), that can be caused by stress, anxiety, fever, meds, etc
-Symptoms: Hypotension, dizziness, LOC changes
-Management: Tx underlying cause, beta-blockers, NO cardioversion

Supraventricular Tachycardia

-Rapid heart rhythm(150-250 bpm, that can suddenly start and stop, and can be caused by meds, stress, or faulty electrical signals from the heart
-Symptoms: Palpitations, dizziness, chest pressure, anxiety
-Management: Vagal Maneuvers(apply cold, gagging, coughing), rapid IV push of Adenosine, cardioversion if unstable

Atrial-Fibrillation(A-Fib)

-Irregular, often rapid heart beat that causes decreased cardiac output and blood pooling
-Symptoms: Palpitations, dizziness, chest pressure, anxiety
-Mangement: Control the heart rate(metoprolol), control the rhythm(amiodarone, cardioversion), anticoagulants

Ventricular Fibrillation

-Heart ventricles stop pumping blood leading to no cardiac output(QUIVERS)-Most common in sudden cardiac arrest
-Symptoms: Collapse, LOC
-Management: CPR, defibrillation, epinephrine, amiodarone

Asystole

-Heart completely stops, and there is no pulse, breathing, or consciousnsess(NO QUIVER)
-Management: CPR, Epinephrine, DO NOT DEFIBRILLATE, identify the reversible cause

Pulselessness Electrical Activity(PEA)

-Heart shows a regular rhythm on a monitor, but is not actually pumping blood(no pulse)
-Management: CPR, Epineprine q3-5 mins, NEVER SHOCK, tx the reversible cause!

Angina Pectoris

-Chest pain caused by reduced blood flow to the heart
-Stable Angina: Pain that occurs during exertion, but is relieved by rest and nitro
-Unstable Angina: Pain that occurs randomly and at rest(precursor to MI)
-Nursing Interventions: Stop activity and rest, O2, Nitro 1 tablet q5 mg x3, EKG monitoring, assess pain

Coronary Artery Disease

-Restriction of blood flow and oxygen in the arteries due to the buildup of plaque
-Symptoms: Chest pain/pressure, dyspnea, palpitations, SOB with exertion, weakness
-Management: Statins, beta-blockers, ACE inhibitors, nitrates, antiplatelets

Peripheral Arterial Disease(PAD)

-Narrowing/blockage of the arteries in the peripheral extremities, resulting in a decreased blood supply.
-Symptoms: Pain at rest that is worse at night, ulcers on toes with smooth edges, cool, pale skin, weak/absent pulse
-Management: Hang legs(NO elevation), avoid tight clothing, antiplatets, warm environment

Peripheral Venous Disease(PVD)

-When one's veins are stretched out, weak, and thin, from an underlying problem(diabetes, COPD), preventing blood from returning to the heart, resulting in blood clots
-Symptoms: Warm, swollen limbs, brown discolaration, thick skin, edema, ulcers around the ankles(irregular edges)
-Management: Elevate legs, compression stockings, moist wound care, avoid standing for long periods, walk/exercise

Acute Coronary Syndrome(ACS)

-Sudden decrease in blood flow to the heart, that is diagnosed by an elevation in troponin
-STEMI: Complete blockage of the coronary artery causing a heart attack, that is diagnosed by an ST ELEVATION(PCI)
-NSTEMI: Partial blockage of the coronary artery causing a heart attack, that is diagnosed by an ST DEPRESSION
-Symptoms: Chest pain/pressure radiating to arm/jaw/back, SOB, sense of impending doom
-Management: Nitro, EKG, antiplatelet, O2, morphine

Percutaneous Coronary Intervention(PCI)

-Procedure that opens blocker coronary arteries to improve blood flow(goal is within 90 mins), and is the gold standard for a STEMI
-Post Procedure Management: Avoid bending knees, coughing, sneezing, strict bed rest if there is a femoral site, monitor cardiac function and chest pain

Myocardial Infarction(MI)

-When blood flow to the heart stops, resulting in the death of heart tissue
-Symptoms: Sudden onset of tight, crushing, severe pain that radiates to the back/neck/jaw/shoulder, and is unrelieved by nitro, tachycardia, denial, hypotension
-Management: Low sodium, low cholesterol, and low caffeine diet, O2 and meds

Coronary Artery Bypass Graft(CABG)

-Surgical procedure that creates a new pathway for blood to flow and is used when PCI/meds are not effective, and for patients with severe vessel damage

Cardiomyopathy

-Heart disease that causes it to become enlarged, thickened, or stiff, making it difficult to pump blood
-Dilated Cardiomyopathy: Enlarged ventricle
-Hypertrophic Cardiomyopathy: Enlarge and stiff septum
-Restrictive Cardiomyopathy: Stiff ventricle walls
-Symptoms: S3 ventricular gallop, dysrhythmias, dyspnea, edema
-Management: Heart transplant for end-stage disease, ACE inhibitors, beta-blockers, diuretics, anticoagulants, ICD/pacemaker

Pericarditis

-Inflammation of the pericardial sac surrounding the heart
-Symptoms: Sharp chest pain that worsens with breathing and lying flat, but is relieved by sitting forward
-Management: NSAIDS, corticosteroids, antibiotics

Congestive Heart Failure(CHF)

-When the heart is unable to pump enough blood to meet metabolic demands, which is caused by MI, HTN, Coronary Artery Disease, cardiomyopathy, etc
-Diagnosis: Increased BNP, enlarged heart, fluid in the lungs
-Management: ACE inhibitors, diuretics, beta blockers, digoxin, aldosterone antagonists(WANT TO REDUCE STRESS ON THE HEART)

Left-Sided Heart Failure(LUNGS/RESPIRATORY)

-Symptoms: Crackles, wheezes, cough, tachypnea, tachycardia, orthopnea

Right-Sided Heart Failure(REST OF BODY+FLUIDS)

-Symptoms: JVD, edema, ascites, increase in peripheral venous pressure, weight gain

P wave

Represents heart muscle contraction/initiation of a heartbeat(top chambers)

QRS Interval(bottom chambers)

Time it takes for the heart's ventricles to contract, representing the heart's electrical signal