Atherosclerosis is most common cause Thrombus from atheroma may obstruct artery

Atherosclerosis is most common cause • Thrombus from atheroma may obstruct artery • Vasospasm is cause in a small percentage • Size and location of the infarct determine the damage Warning Signs of Heart Attack • Feeling pressure, heaviness, or burning in chest especially with increased activity • Sudden shortness of breath, weakness, fatigue • Nausea, indigestion, anxiety and fear • Pain may occur and if present is usually substernal, crushing, and radiating Diagnostic Test • ECG changes, serum enzymes and Isoenzymes • Serum levels of myosin, cardiac troponin are elevated • Leukocytosis, elevated CRP, and ESR common • Arterial blood gas and pulmonary artery pressure Complications • Sudden death Treatment • Reduce the cardiac demand • Oxygen therapy • Analgesics • Anticoagulants • Thrombolytic agents may be used • Tissue plasminogen activator • Medication to treat: Dysrhythmias, hypertension, congestive heart failure • Cardiac rehabilitation begins immediately Cardiac Dysrhythmias

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What’s the problem? ** Cardiac Output is the problem- that is all she said to know for dysrhythmias Sinus node abnormalities - pacemaker of the heart, which alters rate • Bradycardia- regular but slow heart rate • Tachycardia- regular rapid heart rate • Sick sinus syndrome- marked by alternating bradycardia and tachycardia often requiring mechanical pacemaker Atrial Contraction Abnormalities • Premature atrial contractions (PAC)- extra contraction or ectopic beats  irritable atrial muscle cells outside the conduction pathway • Atrial fibrillation- rate over 350 beats/min causing pooling of blood in the atria and a risk for thrombus formation Atrial Node Abnormalities • Heart block- conduction is excessively delayed or stopped at AV node/bundle of HIS • First degree- conduction delay between atrial and ventricular contractions • Second degree- every second to third atrial beat is dropped at AV node • Third degree- no transmission from atria to ventricles • Ventricular Conduction Abnormalities • Bundle branch block- interference with conduction in one of the bundle branches • Ventricular tachycardia- likely to reduce cardiac output as reduced diastole occurs • Ventricular fibrillation- muscles fibers contract independently and rapidly and cardiac standstill occurs if not treated immediately • Premature ventricular contractions- additional beat from ventricular muscle cell or ectopic pacemaker. May lead to ventricular fibrillation Treatment of Cardiac Dysrhythmias • Cause needs to be determined and treated • Antidysrhythmic drugs are effective in many cases • SA nodal problems or total heart bock require pacemakers • Defibrillator may be implanted for conversion of ventricular fibrillation Cardiac Arrest • Cessation of all heart activity – no conduction of impulses, flat ECG Many reasons cause this: • Excessive vagal nerve stimulation • Potassium imbalance, cardiogenic shock • Drug toxicity, insufficient oxygen •