Module 6: Cardiovascular Emergencies

By the end of this module, you will be able to:

• Recognize the signs and symptoms of common cardiovascular emergencies.

• Understand the pathophysiology of conditions such as myocardial infarction and angina.

• Provide appropriate pre-hospital care for patients experiencing cardiac emergencies.

• Perform CPR and use an AED effectively.

Structure

• Heart Anatomy

  • Four chambers: Right atrium, right ventricle, left atrium, left ventricle.

  • Valves: Tricuspid, pulmonary, mitral, aortic.

• Blood Vessels

  • Arteries: Carry oxygenated blood away from the heart.

  • Veins: Carry deoxygenated blood back to the heart.

  • Capillaries: Site of nutrient and gas exchange.

Function

• Circulation

  • Pulmonary Circulation: Between heart and lungs.

  • Systemic Circulation: Between heart and rest of the body.

• Electrical Conduction System

  • SA Node: Heart's natural pacemaker.

  • AV Node, Bundle of His, Purkinje Fibers: Coordinate contractions.

Common Conditions

• Acute Coronary Syndrome (ACS)

  • Includes: Myocardial infarction (heart attack), unstable angina.

  • Symptoms: Chest pain or discomfort, pressure, radiating pain to arm/jaw, shortness of breath, nausea, diaphoresis.

• Angina Pectoris

  • Stable Angina: Chest pain with exertion, relieved by rest or nitroglycerin.

  • Unstable Angina: More severe, can occur at rest.

• Myocardial Infarction (MI, Heart Attack)

  • Cause: Blockage of coronary artery leading to ischemia and death of heart muscle tissue.

  • Symptoms: Similar to angina but not relieved by rest.

• Congestive Heart Failure (CHF)

  • Symptoms: Shortness of breath, edema, fatigue.

  • Cause: Heart's inability to pump effectively.

• Cardiac Arrest

  • Definition: Complete cessation of heart function. (Heart stops beating, pulse = 0)

Assessment

• Primary Assessment

  • Ensure airway, breathing, circulation.

  • Check responsiveness, call for additional help.

• History

  • Use OPQRST and SAMPLE.

  • Ask about cardiac history, medications (ex., nitroglycerin, aspirin).

Interventions

• Administer Oxygen

  • Based on patient's oxygen saturation and signs of hypoxia.

• Assist with Medications

  • Nitroglycerin

    • Indications: Chest pain suspected to be cardiac.

    • Contraindications: Hypotension (BP < 100 mmHg) or head injury.

    • Administration: Sublingual tablet or spray.

  • Aspirin

    • Dose: 160-325 mg chewable.

    • Purpose: Anti-platelet effect to reduce clot formation.

• Cardiopulmonary Resuscitation (CPR)

  • Indications: Unresponsive, no normal breathing, no pulse.

  • Compression Rate and Depth:

    • Rate: 100-120 compressions per minute.

    • Depth: At least 2 inches (5 cm) in adults.

• Automated External Defibrillator (AED)

  • Usage Steps:

    • Turn on AED.

    • Attach pads to patient's bare chest.

    • Follow prompts (ensure no one is touching patient during analysis and shock).

• Rapid Transport

  • Time is crucial in cardiac emergencies.