ANGINAMYOCARDIAL INFARCTION

HEART BLOCKCONGESTIVE HEART FAILURE

DISORDERS OF THE HEART

OBSERVATIONS TO REPORT IN PATIENT’S WITH CARDIAC DISORDERS

Color changesChanges in pulse rate or rhythmChanges in BPEdemaDisorientationPt. c/o SOBPt. c/o chest pain/pressure/discomfortDiaphoresisPt. c/o N&V Subjective or Objective????

ANGINA PECTORIS

“Pain of effort”- when coronary arteries are unable to carry enough blood to meet the heart’s demand for oxygen

Can develop gradually or suddenlyIncrease stress on heart

ANGINA PECTORIS

Factors that could bring on an attack: Exertion Heavy eating Emotional stress

ANGINA PECTORIS

S&S:Pain with exertion/exercisePain/pressure/discomfort Pale/flushed faceDiaphoretic

Treatment:DrugsAvoid stress/sudden exertion

MYOCARDIAL INFARCTION (MI)

Heart attack:An acute MI occurs when the coronary arteries are blocked. Part of the heart muscle supplied by these vessels becomes ischemic. Unless circulation is restored quickly, the cells die (infarction)

MYOCARDIAL INFARCTION

Can be caused by occlusion in coronary artery that “feeds” the heart.

MYOCARDIAL INFARCTION

S&S:Pain/discomfort/pressure in chest

Heaviness in arm RestlessnessN&V CyanosisIrregular pulse/respirationsDiaphoreticAnxiety/weaknessSOBSyncopeHypotension

MYOCARDIAL INFARCTION

Treatment is directed towards:1. Relieving pain2. Reducing heart’s activity (work

load)3. Altering clotting ability of blood

(drugs)4. Administering drugs to dissolve

clot

What is the difference between an MI and an angina attack?

HEART BLOCK

Condition that develops due to interference in the electrical current through the heart. The flow of this electrical current through the heart muscle makes the normal cardiac cycle.Pacemaker- electronic device that is implanted under the chest muscles that carries electrical current through the heart muscle to replace the “lost control.”

CONGESTIVE HEART FAILURE (CHF)

Failure of the R side of the heart to pump efficiently, which results in congestion of the lungs.At first the heart enlarges (hypertrophy) to compensate for additional loads. Eventually, it can no longer maintain flow. Because the weakened heart moves less blood with each pump, fluid backs up in the lungs. The heart looses it’s “squeezing power”, and the heart must work harder to maintain the blood flow.The body (especially lungs)becomes congested with fluid, which is why it is called congestive heart failure.

Causes of CHF

High blood pressureHeart attack Valve problemsObesity

S&S of CHF

DyspneaOrthopnea- difficulty breathing unless sitting

uprightEdemaFatigueCoughAscites- fluid in abd.Confusion associated with hypoxia (not

enough O2)Enlarged heart

S&S of CHF

Treatment of CHF

Drugs to diuresis (urinate to lose fluid)Low sodium dietFluid restrictionDaily weightsHigh fowler’s positionAssist with ADLsMonitor I&OTED stockings

Complications of CHF

Acute Pulmonary Edema- life threatening, acute episode where lungs fill with fluid

Review Questions

1. Why do patients who suffer from R sided heart failure experience pulmonary symptoms?

2. What is the difference between angina and an MI?

3. What is the relationship between coronary arteries, ischemia, and infarction in an MI?

4. What are symptoms of an MI?5. How do we treat heart block?6. Why would you see edema in CHF, especially

in the feet?

Review Questions

7. What position is best for pulmonary edema?9. How is atherosclerosis related to CHF?10. Is a large heart a better functioning heart?

Explain