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Cardiac Emergencies & Conditions - Coggle Diagram
Cardiac Emergencies & Conditions
Cardiac Tamponade
Cardiac Tamponade is a life-threatening emergency which requires immediate medical interventions. This emergency happens when the area surrounding the heart, the pericardium, excessively fills with fluid which then causes compression of the heart, compromising its ability to properly function.
Trauma
Both penetrating and blunt force trauma are capable of causing cardiac tamponade. Typically, penetrating trauma is the more common cause because of the nature of the damage to the body. A penetrating chest wound is able to bring in blood to the area causing improper function. Blunt force trauma is also able to cause contusions to the area which affect the heart in a similar manner.
Procedure complications
In some cases, invasive medical procedures are able to cause damage extensive enough to cause cardiac tamponade. Open-heart surgery is very invasive and has a potential of causing complications. Pacemaker placement as well as central line insertions are some other procedures that can carry the risk of potentially damaging the pericardium.
Beck's Triad
Muffled Heart Sounds
Muffled heart sounds are present in cardiac tamponade because the fluid in the pericardium that affects the heart is a physical barrier that the sound waves cannot get through.
Hypotension
Hypotension occurs because the fluid in the pericardium drastically affects the way that the heart functions. The added pressure around the heart affects the contracting and relaxing of the heart, resulting in lowered blood pressure.
Jugular Vein Distension
In cardiac tamponade, JVD typically occurs because the heart is being compressed; external pressure prevents the heart from pumping blood as it usually does. When the heart doe not pump properly, the blood will back up into the veins (superior vena cava) which causes the jugular vein to appear distended. Alone, JVD is not life threatening, although it is typically a sign of a much worse underlying condition.
Treatment for cardiac tamponade includes a procedure named pericardiocentesis. In this procedure, a needle is inserted into the chest cavity and is then used to drain the excess fluid from the pericardium.
Treatment
Myocardial Infarction
A myocardial infarction, (or MI) is the proper term for what most of us know as a heart attack. This medical emergency happens when there is a decrease of blood flow to the heart muscles.
When one of the coronary arteries become occluded, it leads to a decrease of oxygen delivered to the myocardium (heart muscle) which in turn, leads to death of the heart tissue. If left untreated, the person experiencing an MI can go into cardiac arrest, and death can occur.
Diagnosing an MI is done with multiple methods. The main tool used is a 12-lead ECG which is used to visualize the heart's electrical activity. It can detect branch blocks as well as STEMI's (ST-Elevated Myocardial Infarction)
ECG
Another method of evaluating a potential MI is by checking biological markers, such as specific proteins than would not be regularly found at elevated levels in your bloodstream. Troponin is a protein than can be found in the heart muscle that when detected in the blood, can indicate than cardiac muscle death has occurred
Bio Markers
When detected, an MI needs immediate interventions to prevent further damage to the myocardium. Typically this is done through angioplasty, where a catheter is guided to the occluded artery where the vessel is then widened slightly to reduce the blockage. In some cases, a wire mesh or "stent" can be placed to prevent blockages in that area again.
Treatment
Many factors can be taken into account when determining if a person is at risk for an MI. Some conditions include hypertension, high cholesterol, sedentary lifestyle, severe stress, and drug use. The most common way to avoid a cardiac event such as this would be to make some lifestyle changes.
Risk Factors
Cardiac Arrest
Cardiac arrest (SCA) occurs when the heart suddenly stops beating. It is also characterized by the cessation of breathing. When untreated in a timely manner it can lead to sudden death. It is one of the leading causes of death in the US.
SCA can happen suddenly, but it more commonly occurs from the worsening of underlying heart conditions.
SCA is a condition which requires immediate medical interventions. During cardiac arrest the heart may take on irregular rhythms, such as ventricular fibrillation, ventricular tachycardia (pulseless & non-pulseless), pulseless electrical activity, or asystole. Treatment for a patient varies depending on the rhythm.
Shockable rhythms include V-Fib and pulseless V-Tach. When it comes to these, a defibrillator along with high-quality CPR can be used in order to restore the heart back to sinus rhythm.
Non-shockable rhythms like asystole and PEA do not benefit from defibrillation like the other rhythms. In cases like these, only CPR and certain ALS measures can be performed in order to restore the heart's rhythm
Despite being slightly different, both of these conditions share some similar qualities. Aside from performing CPR, some medications are also given to the patient, these include epinephrine(vasoconstrictor), amiodarone(antiarrhythmic used with shockable rhythms. In addition, fluids can be administered via IV if hypovolemia is suspected.
Hypoxia
Hypoxia itself is usually not the main cause for cardiac arrest. however, its effects on systems in the body have a great impact on the heart's function. When the body does not have enough oxygen it causes tissue to die and the whole body does not have enough oxygen to function properly
Electrical Issues/Imbalances
One of the lesser thought of reasons for cardiac arrest is due to electrical problems within the heart. In order for the heart to beat, it uses self regulated electrical pulses to function. Potassium is one of the minerals/electrolytes that your heart needs in order to regulate its electrical function. In extreme situations (hypo/hyperkalemia) too much or too little potassium can affect the hearts function which can lead to abnormal tachycardia, skipped beats, and palpitations; all which can lead to SCA if untreated.
For hyperkalemia, medical professionals will give their patient treatments that help the body get rid of the excess potassium. Some treatments include diuretics, managing which medications the patient is taking (like less ACE inhibitors which have a change of increasing the chances of hyperkalemia), IV therapy, and in some cases, even dialysis.
For hypokalemic patients, treatment is more straightforward. In mild to moderate cases, an oral potassium supplement can be taken to raise the levels of potassium in the body. In more severe cases, IV therapy can be used in order to more effectively give the patient potassium.
Chronic Conditions
CHF
CHF (congestive heart failure) is a condition where the heart is no longer able to efficiently pump blood for the body. The blood tends to buildup in other parts of the body like the lunch and even the limbs like your feet (peripheral edema)
CHF is a disease than can be managed through life with medications, but it is also one that can progress and get much worse. Living a healthier lifestyle as well as medications such as ACE-inhibitors or beta-blockers can help manage CHF, but more drastic measures have to be taken in the later stages.
Advanced treatment options may have to be taken such as heart surgery or heart transplant. In some cases, ventricular assist devices may have to be used. In the worst cases, palliative care may be the only way to manage this disease
Coronary Artery Disease
CAD is a disease which affects the the heart's vasculature by blocking and narrowing the vessels. This happens when plaque builds up (atherosclerosis) in the coronary arteries, which block the flow of blood which leads to a heart attack (myocardial infarction).
Most people with this condition typically live their lives' as one normally would. CAD is considered a silent killer because the person does lives normally until they experience a heart attack from this condition.
The more common signs and symptoms include dyspnea (shortness of breath) during low intensity activities, as well as angina (chest pain of cardiac origin)
S/S
CAD treatments are very similar to treatments for n MI as they share extremely similar characteristics. This includes treatment in a catheter lab to open up an occluded artery, as well as making healthy lifestyle changes.
Treatment
Cardiomyopathy
Cardiomyopathy is a disease that affects the structure of the heart itself. There are different types of this disease but the following are two examples of how they affect people.
Hypertrophic
With hypertrophic cardiomyopathy (enlarged heart) the wall of the left ventricle is larger or thicker than a normal heart. This leads to less space inside of the actual ventricle which reduces the volume of blood being pumped out to the rest of the heart.
Dilated
With dilated cardiomyopathy, the ventricles expand or "dilate" more than they should, which causes the heart to pump blood less efficiently. This leads to added stress on the heart, and similar to hypertrophic, can lead to heart failure in some cases.
Heart Valve Disease
Heart Valve disease is a condition which affects the properties of the valves inside the heart. The inefficient function of the heart adds more stress and when untreated, can be life-threatening. It causes the valves in your heart to do different things, such as leaking or narrowing of the valve
Over time, this condition can turn into heart failure if untreated. Depending on the valve type and damage, some cases may benefit from a valve replacement or repair