Cardiac Disease and Heart Conditions

Cardiac cell ischemia is a decreased blood flow to the heart muscle, causing heart tissue to fail to get enough oxygen and nutrients, leading to tissue starvation and eventual death if blood flow is not restored.

Atherosclerosis is a diminished blood flow to the myocardium caused by cholesterol and other fatty substances building up and forming a plaque inside the walls of the vessels, leading to a complete occlusion or blockage of a coronary artery.

Arterial sclerosis is a thickening of the arterial walls, causing hardening of the arteries and reducing blood flow.

Thromboembolism is a blood clot that gets stuck at a narrow area, blocking blood flow, and can cause a full blockage in a coronary artery, leading to a heart attack.

Controllable factors contributing to cardiac disease include cigarette smoking, elevated blood pressure, elevated cholesterol levels, diabetes, lack of exercise, and stress.

Uncontrollable risk factors include older age, family history of coronary artery disease, race, and ethnicity.

Acute coronary syndrome is a group of symptoms consistent with acute myocardial ischemia, which can result in angina pectoris or a heart attack, and is treated similarly under the designation of acute coronary syndrome.

Angina pectoris is a brief period when heart tissue is not getting enough oxygen, characterized by a brief discomfort that has a predictable characteristic and is relieved promptly with rest, supplemental oxygen, or nitroglycerin.

Pain experienced by patients is typically described as crushing, squeezing, or like someone standing on their chest, usually felt in the mid-chest under the sternum, but can radiate to the jaw, arms, midback, or epigastrium.

Stable angina occurs at a relatively predictable frequency and is usually relieved by rest and/or medication.

Unstable angina occurs without a predictable frequency and may or may not be relieved by rest and medication.

Progressive angina is stable or unstable angina that is accelerating in frequency and duration.

Acute myocardial infarction (AMI) is the death of cells in the area of the heart where blood flow is being blocked, signaled by pain that differs from angina pain in three ways: it can occur at any time, does not resolve itself in a few minutes, and can last between 30 minutes and several hours.

Signs and symptoms of AMI include possible sudden onset of weakness, nausea, and sweating without an obvious cause, chest pain and discomfort or pressure, pain or discomfort in the lower jaw, arms, back, abdomen, and neck, and sometimes an irregular heartbeat.

The most common symptom of AMI is chest pain, which is often described as heavy, squeezing, crushing, or tight.

Consequences of AMI can be sudden death, usually resulting from cardiac arrest, cardiogenic shock, and heart failure.

Cardiogenic shock is most often caused by a myocardial infarction or heart attack, characterized by the heart lacking enough power to force the proper volume of blood throughout the circulatory system.

Treatment for cardiogenic shock includes putting the patient in a position of comfort, maintaining oxygen saturation above 94%, and assisting ventilations if necessary.

Heart failure occurs when the ventricular myocardium can no longer keep up with the return of blood flow from the atria, often occurring after an MI, heart valve damage, or long-standing high blood pressure.

Left-sided heart failure occurs when the pumping function of the left ventricle is damaged, causing the heart rate to increase and the left ventricle to enlarge.

Right-sided heart failure occurs when the fluid collects in the body, often showing up as swelling in the feet and legs.

General signs and symptoms of heart failure include shortness of breath, agitation, chest pain, distended neck veins, swollen ankles, hypertension, and tachycardia.

Treatment for heart failure includes monitoring the heart rhythm, administering oxygen as necessary, allowing the patient to remain sitting in an upright position, gaining IV access, and transporting the patient.

Pulmonary edema is a common complication of myocardial ischemia that may or may not be the result of an MI, characterized by fluid buildup in the lungs.

Treatment for pulmonary edema involves maintaining airway, breathing, and circulation, and providing rapid transport support for the patient.

Hypertensive emergency is a condition where the systolic pressure is greater than 180 or the diastolic pressure is 120 or greater, requiring rapid transport and establishment of IV access.

Aortic dissecting aneurysm is a weakness in the wall of the aorta, caused by uncontrolled hypertension, characterized by sudden chest pain in the anterior chest or back between the shoulder blades.