NURS 6023 Cardiovascular 2
Where chest pain can occur from - answer cardiac
GI
Pulmonary
MSK problem
what is a chest pain equivalent - answer diaphoresis, fatigue, weakness, SOB, referred
pain
who is more likely to present with atypical cardiac symptoms - answer women
elderly
what should be r/o in all pts w/chest pain - answercardiac origin
differntial dx of chest pain - answerangina/acute coronary syndrome
ischemia
nn ishemic origins
pulmonary
GI
psychogenic
MSK
cause of angina - answerhypoxia to the myocardium --> anaerobic metablosim --> lactic
acid --> build up irritates the heart muscle & makes it hurt
what leads into angina - answer50-70% blockage including some of the small vessels
s/s of angina - answerLevine signs (clenched fist to the chest)
substernal
precipiatted by exertion, emotional experiences, food consumption
NV, diaphoresis, SOB
alleviating factors to angina - answerrest
medication (NTG)
oxygen
stable angina - answerrepetitive pattern
exertional demands
30sec - few minutes
resolves w/rest or meds
unstable angina - answerescalating pattern (getting worse)
, may occur at rest
may wake up pt
pain is longer than a few minutes but less than 20 min
may take longer to recover
may need IV ntg to recover
home NTG not working
Acute Coronary Syndrome Classifications - answerunstable angina, NSTEMI, STEMI
ACS s/s - answernew ischemic 12 lead ekg changes
elevated cardiac biomarkers (troponin)
angina > 20 mins
new onset angina limited physical ability
angina occuring more frequently
where does inferior MI show on leads - answerRCA
II, III
ADF
where does lateral Mi show on leads - answerI
AVL
B5, B6
where does septal MI show on leads - answerLAD
UAC
V1, V2
where does anterior MI show on leads - answerinvolves LAD
V3, V4
in pts who are infarcting what might you see on ecg - answerST elevation
What ecg wave would you see in someone who has already infarcted - answerST
depression
what is demand ischemia - answermismatch between myocardial )2 demand & supply
ex: aortic valve disease, HTN, tachy/brady arrythmiassevere anemia (decreased
hemoglobin carrying capacity of O2)
ischemia occurs not d/t blockage
pericarditis - answerinflammation of the sac surrounding the heart (pericardial sac)
When might pericardial pain occur - answerFollowing myocardial infarction
after a procedure like CABG
viral infections and thoracic radiotherapy
Where chest pain can occur from - answer cardiac
GI
Pulmonary
MSK problem
what is a chest pain equivalent - answer diaphoresis, fatigue, weakness, SOB, referred
pain
who is more likely to present with atypical cardiac symptoms - answer women
elderly
what should be r/o in all pts w/chest pain - answercardiac origin
differntial dx of chest pain - answerangina/acute coronary syndrome
ischemia
nn ishemic origins
pulmonary
GI
psychogenic
MSK
cause of angina - answerhypoxia to the myocardium --> anaerobic metablosim --> lactic
acid --> build up irritates the heart muscle & makes it hurt
what leads into angina - answer50-70% blockage including some of the small vessels
s/s of angina - answerLevine signs (clenched fist to the chest)
substernal
precipiatted by exertion, emotional experiences, food consumption
NV, diaphoresis, SOB
alleviating factors to angina - answerrest
medication (NTG)
oxygen
stable angina - answerrepetitive pattern
exertional demands
30sec - few minutes
resolves w/rest or meds
unstable angina - answerescalating pattern (getting worse)
, may occur at rest
may wake up pt
pain is longer than a few minutes but less than 20 min
may take longer to recover
may need IV ntg to recover
home NTG not working
Acute Coronary Syndrome Classifications - answerunstable angina, NSTEMI, STEMI
ACS s/s - answernew ischemic 12 lead ekg changes
elevated cardiac biomarkers (troponin)
angina > 20 mins
new onset angina limited physical ability
angina occuring more frequently
where does inferior MI show on leads - answerRCA
II, III
ADF
where does lateral Mi show on leads - answerI
AVL
B5, B6
where does septal MI show on leads - answerLAD
UAC
V1, V2
where does anterior MI show on leads - answerinvolves LAD
V3, V4
in pts who are infarcting what might you see on ecg - answerST elevation
What ecg wave would you see in someone who has already infarcted - answerST
depression
what is demand ischemia - answermismatch between myocardial )2 demand & supply
ex: aortic valve disease, HTN, tachy/brady arrythmiassevere anemia (decreased
hemoglobin carrying capacity of O2)
ischemia occurs not d/t blockage
pericarditis - answerinflammation of the sac surrounding the heart (pericardial sac)
When might pericardial pain occur - answerFollowing myocardial infarction
after a procedure like CABG
viral infections and thoracic radiotherapy
