APEA 3P Pathophysiology -
Cardiovascular
abdominal aortic aneurysm - ANS-s/s: typically asymptomatic; abdominal, back, flank pain.
classic triad: acute abdominal pain, abdominal distention, hemodynamic instability
risks: older, white adult males, current or former smoker, hypertension
diagnostics: incidental finding on chest x-ray may show widened mediastinum, tracheal
deviation, and obliteration of aortic knob (thoracic aortic dissection). Initial imaging test is
abdominal ultrasound.
\acute coronary syndrome - ANS-refers to clinical presentations ranging from ST-elevation
myocardial infarction (STEMI) to non-ST-elevation myocardial infarction (NSTEMI) and unstable
angina.
s/s: constant chest or substernal discomfort lasting > 15 min described as squeezing, tightness,
crushing, knot in the center of the chest, heavy pressure "elephant on chest", diaphoresis,
palpitations, SOB, N/V,
some report that pain radiates to the inner aspect of one or both arms, shoulders, neck, and/or
jaw. the pain can radiate to the back (interscapular region).
some women, older adults and those with diabetes may have atypical presentations such as
epigastric discomfort, indigestion, nausea and/or vomiting, new-onset fatigue, and dizziness. at
other times, the pain is unpredictable or gets worse with rest (unstable angina)
precipitating factors: physical exertion, emotional upset, or eating a heavy meal
dx: best initial diagnostic test is the 12-lead EKG. some patients with myocardial infarction (MI)
may have a normal to nonspecific EKG.
assessment airway, breathing, and circulation.
tx: all patients with suspected ACS should be given an aspirin dose of 162 to 325 mg to chew
and swallow, unless contraindicated.
Call 911
\bacterial endocarditis - ANS-a bacterial inflammation that affects the endocardium or the heart
valves - bacteria attaches to diseased endocardium or heart valves
high mortality
s/s fever, chills, new onset murmur, anorexia, weightloss, splinter hemorrhages, petechiae on
palate, Osler nodes, janeway lesions, Roth spots
Cardiovascular
abdominal aortic aneurysm - ANS-s/s: typically asymptomatic; abdominal, back, flank pain.
classic triad: acute abdominal pain, abdominal distention, hemodynamic instability
risks: older, white adult males, current or former smoker, hypertension
diagnostics: incidental finding on chest x-ray may show widened mediastinum, tracheal
deviation, and obliteration of aortic knob (thoracic aortic dissection). Initial imaging test is
abdominal ultrasound.
\acute coronary syndrome - ANS-refers to clinical presentations ranging from ST-elevation
myocardial infarction (STEMI) to non-ST-elevation myocardial infarction (NSTEMI) and unstable
angina.
s/s: constant chest or substernal discomfort lasting > 15 min described as squeezing, tightness,
crushing, knot in the center of the chest, heavy pressure "elephant on chest", diaphoresis,
palpitations, SOB, N/V,
some report that pain radiates to the inner aspect of one or both arms, shoulders, neck, and/or
jaw. the pain can radiate to the back (interscapular region).
some women, older adults and those with diabetes may have atypical presentations such as
epigastric discomfort, indigestion, nausea and/or vomiting, new-onset fatigue, and dizziness. at
other times, the pain is unpredictable or gets worse with rest (unstable angina)
precipitating factors: physical exertion, emotional upset, or eating a heavy meal
dx: best initial diagnostic test is the 12-lead EKG. some patients with myocardial infarction (MI)
may have a normal to nonspecific EKG.
assessment airway, breathing, and circulation.
tx: all patients with suspected ACS should be given an aspirin dose of 162 to 325 mg to chew
and swallow, unless contraindicated.
Call 911
\bacterial endocarditis - ANS-a bacterial inflammation that affects the endocardium or the heart
valves - bacteria attaches to diseased endocardium or heart valves
high mortality
s/s fever, chills, new onset murmur, anorexia, weightloss, splinter hemorrhages, petechiae on
palate, Osler nodes, janeway lesions, Roth spots
