Lesson no. 1
Cardiovascular Emergencies
This is a chronic and asymptomatic process that begins at an early age. A layer of lipid plaque, muscle cells, white blood cells, etc. sinks between the inner layers of the arteries and narrows them.
Atherosclerosis becomes symptomatic as the plaque significantly constricts the artery and disrupts blood flow to the heart muscle.
When the heart does not receive the oxygen necessary for its activity, it will signal this deficiency through pain.
This is a chronic and asymptomatic process that begins at an early age. A layer of lipid plaque, muscle cells, white blood cells, etc. sinks between the inner layers of the arteries and narrows them.
Atherosclerosis becomes symptomatic as the plaque significantly constricts the artery and disrupts blood flow to the heart muscle.
When the heart does not receive the oxygen necessary for its activity, it will signal this deficiency through pain.
Factors
The causes of atherosclerosis are divided into controllable and uncontrollable factors:
Controllable: Smoking, proper nutrition, exercise, weight watching, mental stress, untreated diabetes, untreated high blood pressure.
Uncontrollable: age, gender (especially men) and heredity.
Prevention
So what can we do to prevent this?
An Israeli study of 25 to 45 year-olds found that maintaining a healthy breakfast lowers the lipid content levels in blood, reducing the likelihood of having a heart-related incident by half!
Angina Pectoris is known more commonly as chest pain.
These are chest pains caused by the process of atherosclerosis, which narrows the coronary arteries and as a result causes the heart to undergo ischemic (blood supply deficiency) processes.
In all cases of chest pain, it is important to rush the patient to the hospital for fear that it is a complete obstruction of the coronary arteries requiring immediate treatment (myocardial infarction) or that the patient may need further clinical evaluation and supervision.
Complete blockage of a coronary artery that nourishes a segment of the heart.
A layer of atherosclerotic plaque from the inner layer of the blood vessels can rupture, forming a “wound” in the coronary artery.
The body, trying to protect itself, activates the coagulation system which creates a blood clot at the site. The blood clot grows until it blocks the entire artery and prevents the circulation of blood (including oxygen and glucose) to a segment of the myocardium which causes ischemia.
Main signs:
Other signs:
In the field, we may suspect that this is a myocardial infarction based on the patient’s clinical signs and ECG examination.
In order to be able to diagnose accurately, we need to do a blood test that looks for specific substances that are only secreted when there is myocardial death, so we will always take the patient to the hospital to see if it is an infarction or other pain.
Arrhythmia (the most common cause of death from infarction), myocardial rupture, heart failure, pulmonary edema, cardiogenic shock.
Pay Attention!!!
It is a common mistake to think that a person having a heart attack will have a change in heart rate or must be unconscious.
During a heart attack, a patient is conscious and their heart rate can also be normal!
Myocardial infarction can be experienced without any chest pain, especially in diabetics, the elderly and alcoholics, who do not have properly functioning nervous systems.
The signs displayed, as mentioned, can be weakness, difficulty in breathing and paleness – so we need to increase vigilance, ask more questions and err on the side of safety so that we can suspect myocardial infarction by the patient’s appearance!
Cardiac arrest is a condition where the heart stops beating and as a result blood does not circulate throughout the body.
When we talk about cardiac arrest we always talk about mechanical cardiac arrest, although even when there is no mechanical heart activity this does not mean there is no electrical activity. Cardiac arrest and severe arrhythmia will not allow adequate blood circulation to the body.
When we connect a patient to a defibrillator during CPR, we want to see if providing a shock from the defibrillator resets the heart’s electrical activity (creating asystole) and allows it to return to its normal pace.
Treatment
The treatment for these conditions is CPR and calling an ambulance.
During cardiac arrest and PEA the defibrillator will not recommend providing a shock as cardiac activity is already reset in these situations.
A chronic condition caused by death or injury to heart tissue.
Let’s imagine the heart’s activity as a bucket being filled by a cup; normally the cup will take a fixed amount of water every time it is emptied into the bucket. Heart failure is a condition where there is a hole in the cup. Now the cup will not transfer the same amount of water as it loses water on its way to the bucket. Thus the heart is not able to pump the same amount of blood as it used to.
Due to a lack of forward blood circulation (to the body), blood accumulates in the chest area and the fluid from the blood escapes to the lungs. This is called a “pulmonary edema” and is a life-threatening condition.
Deterioration can be extremely rapid.
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