Cardiac emergency

Cardiac emergency

1. CARDIAC EMERGENCY Prepared by, Mrs. Rijo Lijo Lecturer.

2. CARDIAC EMERGENCY Myocardial infarction. Angina pectoris. Congestive cardiac failure. Cardiac arrest. Cardiac tamponade . Cardiogenic shock.

3. MYOCARDIAL INFARCTION. A myocardial infarction (MI), also known as a heart attack, occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle.

4. CAUSES OF MYOCARDIAL INFARCTION Smoking. Sedentary lifestyle. Family history of heart disease. Postmenopausal women. Men over age of 50.

5. MANAGEMENT OF MYOCARDIAL INFARCTION. Medication First aid: Oxygen therapy and drugs that reduce blood clotting and help in maintaining blood flow are given. Clot-busting medicines (thrombolytic medicines): To dilute the clots formed in the arteries. Eg : Tenecteplase .

6. Coronary angioplasty and stenting : Metal mesh stent is inserted into the artery to keep it open and restore blood flow to heart. Coronary artery bypass graft (CABG) : Bypass surgery that allows blood flow to the heart.

7. ANGINA PECTORIS. Is a condition marked by severe pain in the chest, often also spreading to the shoulders, arms, and neck, owing to an inadequate blood supply to the heart.

8. CAUSES OF ANGINA PECTORIS Hypertension. Food high in immersed fat and cholesterol. The absence of physical activity. Cigarette smoking. Type 1 diabetes and Type 2 diabetes. Family history. Older age. Extreme enthusiastic anxiety. Obesity. Stress.

9. MANAGEMENT OF ANGINA PECTORIS Medication Nitrates : Nitrates enable more blood to stream into the heart muscle. Eg : Nitroglycerin. Antiplatelet agents : Medications that help to prevent blood clot formation. Eg : Aspirin. Beta blockers : Medication that blocks the effect of epinephrine hormone. As a result, the heart beats slowly resulting in reduced blood pressure. Eg:Acebutolol .

10. Statins : Drugs used to bring down blood cholesterol. Eg:Atorvastatin . Calcium channel blockers : Medication that widens the blood vessels and increases blood flow in the heart. Eg : Amlodipine .

11. Medical procedures: Angioplasty and stent placement. Coronary artery bypass graft (CABG).

12. Congestive cardiac failure. Congestive heart failure is a weakening of the heart caused by an underlying heart or blood vessel problem.

13. CAUSES OF CONGESTIVE CARDIAC FAILURE. Coronary artery disease (CAD). Heart attack. Cardiomyopathy . Overworking of heart. Ethnicity – Common among African Americans.

14. MANAGEMENT OF CONGESTIVE CARDIAC FAILURE. Medication Angiotensin -converting enzyme (ACE) inhibitors : Converting enzyme inhibitors (ACE inhibitors)helps to open narrowed blood vessels. Eg : Benazepril . Beta blockers : To reduce blood pressure and slow down heart rate. Eg : Acebutolol . Diuretics : To reduce fluid content in the body. Eg : Metolazone .

15. Medical procedures: Coronary artery bypass graft (CABG) · Heart valve surgery. Heart transplant.

16. CARDIAC ARREST Cardiac arrest, also known as cardiopulmonary arrest or circulatory arrest, is the end of normal circulation of the blood due to failure of the heart to contract effectively.

17. CAUSES OF CARDIAC ARREST Smoking. Sedentary lifestyle. High blood pressure. Obesity. Family history of heart disease. History of a previous heart attack. Age over 45 for men, or over 55 for women. Male gender. Substance abuse. Low potassium or magnesium.

18. MANAGEMENT OF CARDIAC ARREST Early recognition. Early CPR . Early defibrillation. Medications- This includes the use of epinephrine, atropine, and amiodarone . Vasopressin overall does not improve or worse outcomes but may be of benefit in those with a systole especially if used early.

19. CARDIAC TAMPONADE. Cardiac tamponade is the accumulation of pericardial fluid, blood, pus, or air within the pericardial space that creates an increase in intra-pericardial pressure, restricting cardiac filling and decreasing cardiac output.

20. CAUSES OF CARDIAC TAMPONADE. Severe chest injury. Heart attack. Hypothyroidism, or an underactive thyroid. Inflammation of the pericardium, which is called pericarditis . Aortic dissection. Bacterial infection. Tuberculosis ( tb ). Kidney failure.

21. MANAGEMENT OF CARDIAC TAMPONADE. Pericardiocentesis . The removal of fluid from the pericardium using a needle. Pericardiectomy . The surgical removal of part of the pericardium to relieve pressure on the heart. Thoracotomy . A surgical procedure that allows the draining of blood or blood clots around the heart.

22. CARDIOGENIC SHOCK. A condition where the heart is unable to pump enough oxygen-rich blood to the body organs.

23. CAUSES OF CARDIOGENIC SHOCK. Pulmonary embolism (sudden blockage of a blood vessel in the lung). Pericardial tamponade ( fluid buildup around the heart, reducing its filling capacity). Sudden valvular regurgitation(allowing the backflow of blood).

24. MANAGEMENT OF CARDIOGENIC SHOCK. Medication Inotropic drugs: To improve heart function. Eg : Dobutamine . Antiplatelets : To prevent clot formation. Eg:Tirofiban . Thrombolytics : Dissolve clots that may be blocking adequate blood flow to the heart. Eg:Reteplase .

25. Surgical Management: Balloon pump : Dilates pulmonary artery to allow blood flow. Angioplasty and stent placement : Widens the blocked artery and a stent is placed. Heart transplant : If the damage to the heart cannot be repaired, it is replaced with a healthy heart from a donor. Heart valve repair : In order to correct the underlying regurgitation.