what are 5 common cardiac conditions?
- coronary heart disease
- angina pectoris
- acute coronary syndrome
- heart failure
what is coronary heart disease?
when coronary arteries become narrowed by gradual build up of fat within their walls
what is atherosclerosis?
process of plaque build up inside your arteries
what is the fatty material called that builds up in your arteries?
what are risk factors for CHD?
- high chol
- no PA
- fam his
- ethnic background
what is angina pectoris?
ischemic chest pain due to reduced blood supply to myocardium
what is the reduced blood supply in angina caused by?
narrowing of the cardiac arteries due to CHD
what are the signs and symptoms of angina pectoris ?
- occurs on exertion or during emotional stress
- pain behind sternum running length of the bone and spreading across chest
- pain sometimes radiates to jaw, throat, teeth, axilla & arms
- short, sharp breathing
- variable pulse
- pallor/ nausea
- pain subsides with rest (stable)
what is the general treatment for angina?
- DR ABCDC
- place patient at rest
- reduce workload of the heart- avoid walking, moving excessively
- consider GTN- dilates coronary arteries (check BP first)
- analgesia as required
what is heart failure?
failure of the heart to pump adequately
what can heart failure be?
- left ventricular failure
- right ventricular failure
- congestive cardiac failure
- combination of LVF and RVF
what are the most common causes of heart failure?
what other 5 things can heart failure be caused by?
- heart valve problems
- alcohol or recreational drugs
- uncontrolled irregular heart rhythm
- congenital heart conditions
- viral infection affecting the heart muscle
what are the 3 common symptoms of someone with heart failure?
what symptom may present with RVF?
what symptom may present with LVF and then RVF eventually?
what other symptoms may present with heart failure?
- worsening cough
- pink frothy sputum
- waking at night gasping for breath
- breathlessness on lying down
- anxiousness/ restlessness
in LVF, what is pulmonary oedema a result of?
reduced cardiac output and increasing pulmonary hypertension
what may present with pulmonary oedema?
- fine crackles on listening of the lungs
- coughing of frothy sputum, white or pink (blood stained) in colour
In RVF, what is peripheral oedema a result of?
- reduced RV output
- increasing systemic congestion
In peripheral oedema, what increases?
- accumulation of fluid in the interstitial spaces
- in excess of 5 litres
- commonly in legs or sacrum
how should you sit a pt with ? heart failure?
upright where possible
what are the signs of adequate perfusion?
- normal mentation
- peripheral pulses present
- BP >90 mmHg
- not pale
- cap refill normal
what are signs of inadequate perfusion?
- reduced LOC
- BP <90 mmHg
- delayed cap re-fill
what are signs of congestion?
- pulmonary oedema
- peripheral oedema
when would you consider salbutamol of a person in heart failure?
when there is a wheeze present
when can you use GTN spray and why?
- when BP >90 mmHg
- as it is a vasodilator
when should you give o2 for heart failure?
what are the 3 main types of cardiomyopathy?
- arrhythmogenic right ventricular
what is cardiomyopathy?
- deterioration of the function of the myocardium
- usually leading to heart failure
what are common symptoms of cardiomyopathy?
- peripheral oedema
what are people with cardiomyopathy at risk of?
- irregular heart beats
- sudden cardiac death
what is the most common form of cardiomyopathy?
- a weakened and enlarged heart
how many people in the uk die each week from sudden cardiac death?
12 apparent fit and healthy young people aged <35