NURS480 Week 3: Cardiac and Perfusion

Acute Coronary Syndrome (ACS)

• ACS is a continuum from angina to Myocardial Infarction (MI), resulting from an imbalance of myocardial oxygen supply and demand.
• Blood supply to the heart muscle is suddenly blocked by a thrombus made of plaque, leading to ischemia and chest pain.

Angina

• Anginal pain: tight squeezing, heavy pressure, or constricting feeling in the chest that can radiate to the jaw, neck, or arm.
• Angina types:
  • Stable (exertional) angina: occurs with exercise or emotional stress and is relieved by rest or nitroglycerin.
  • Unstable (pre-infarction) angina: occurs at rest, increases in occurrence, severity, and duration over time.
  • Variant (Prinzmetal’s) angina: due to coronary artery spasm, often occurring during periods of rest.

Myocardial Infarction (MI)

• STEMI: complete blockage, no blood flow, true infarction/tissue death (not reversible).
• NSTEMI: narrowing, some blood can be perfused, impaired O2, ischemia (reversible).

Risk Factors

• Male sex or post-menopausal clients
• Ethnic background
• Sedentary lifestyle and hypertension
• Tobacco use
• Hyperlipidemia and obesity
• Excessive alcohol consumption
• Metabolic disorder (DM, hypothyroidism)
• Stress
• Atherosclerotic changes related to aging

Signs and Symptoms + Assessment

• Recognize cues:
  • Palpitations
  • Tachycardia and tachypnea/SOB
  • Diaphoresis – pallor, cool, clammy skin
  • Anxiety and nausea/vomiting – feeling of impending doom
  • Angina = chest pain – substernal or precordial
  • Decreased LOC
• Women may experience MI differently:
  • Vague pain/GI symptoms
  • Pain between shoulders
  • Jaw ache
  • Sensation of choking with exertion

ACS DX Procedures/Labs

• Priority intervention: 12-lead ECG
  • ST depression and/or T-wave inversion = ischemic issues
  • STEMI = rush to hospital
  • NSTEMI = education
• After ECG: retrieve blood to look at cardiac enzymes
• Myoglobin:
  • Earliest marker of injury to cardiac or skeletal muscle
  • No longer evident after 24 hours
  • Not cardiac-specific

This quiz covers cardiac and perfusion topics, including ACS, CABG, pacemakers, aneurysms, and lethal dysrhythmias. Test your knowledge on definitions, types, symptoms, labs, nursing care, medications, and treatment options.