Friday, December 28, 2012

Myocardial Infarction



A myocardial Infarction or heart attack is when blood flow to your heart is blocked for a long enough time that part of your heart muscle is damaged or dies 





          Risk Factors for a heart attack

Age
Diabetes
High Cholesterol
Obesity
Stress
Lack of Physical Activity
Illegal Drug Use


                                 


        Causes of a heart attack


There are many different causes for a heart attack, so it is difficult to find the exact cause of each and every one.  Most heart attacks are caused by a block clot that blocks one of the coronary arteries, which provide blood and oxygen to the heart.


                              When do Heart attacks Occur?



Heart attacks can happen at any time but the most common times for a heart attack to occur are:
after a sudden increase in physical activity
after a sudden, severe emotional or physical stress




   Signs/Symptoms of Heart attack

Chest pain that sometimes radiates to the jaw or left arm
Lightheaded/dizziness
Shortness of breath
Anxiety
Nausea or vomiting
Sweating
Fainting



           Nursing Priorities for a heart attack


Obtain an EKG to check for changes
Place the patient on continuous telemetry monitoring to monitor for cardiac arrhythmias
Place an IV and obtain blood work such as a CBC, BMP, electrolytes, coagulation factors and a troponin
Administer aspirin for the anti platelet properties and administer morphine and nitroglycerin to reduce the pain
Place the patient on oxygen so the heart doesn't have to work as hard

If your patients EKG looks like this... they are having a heart attack


Treatment for a heart attack

If the patient is having a complete heart attack or STEMI they will go to the cardiac cauterization lab immediately to get the heart reperfused quickly
If the patient is having an incomplete heart attack or NSTEMI, the treatment is patient specific and would rely on the cardiologists.  Often times IV heparin will be administered to the patient for its anticoagulation properties 



Friday, December 14, 2012

Pericardial Tamponade


This week I want to talk about PERICARDIAL TAMPONADE. While this diagnosis is not very common, it is life threatening which needs an IMMEDIATE INTERVENTION. 







Pericardial Tamponade: When blood or fluid collects in the pericardium, which is the sac that surrounds the heart.  This fluid prevents the heart ventricles from expanding fully.  The excess pressure from the fluid prevents the heart from functioning normally.  As a result, the body does not get enough blood/oxygen. 



                        Causes            

Stab Wound
Penetrating chest wounds such as a stab wound or gun shot wound
Heart attack (MI)
Heart Surgery




EKG of a patient with a Cardiac Tamponade

                Signs/Symptoms

Tachycardia
Difficulty Breathing
Distended Neck Veins
Anxiety/Restlessness
Weak Peripheral Pulses




Chest Xray of a Cardiac Tamponade
Tests
Chest X-ray
Chest CT 
Echocardiogram






                                              Treatment

Pericardial Window
Pericardiocentesis

The fluid around your heart needs to be drained as quickly as possible.  

This is done by a:
pericardiocentesis- uses a needle to remove the fluid from the pericardial sac 


Pericardial Window- surgical procedure which produces a window to help drain the fluid

Fluids- given to help normalize the blood pressure and heart rate

Oxygen- given to reduce the oxygen demand of the heart



Friday, December 7, 2012

I am an Emergency Room nurse who loves the heart so I have decided to create a blog dedicated to both of these topics.  Hopefully this information will be helpful and educational to both current ED and future nurses.

Each week I will choose different cardiac diagnoses and provide you with:
1)background information
2)signs and symptoms
3)treatment

Hopefully this information will be presented in a fun, interactive, creative, and engaging manner.  Please feel free to share your thoughts and insights.  Ask as many questions as you wish, and I will answer them to the best of my ability.