1) Which of the following is used to distinguish the diagnosis of MI (Myocardial Infarction) from that of Unstable angina?
a) Serum levels of Cardiac Biomarkers (Troponin, CK-MB)
b) Electrocardiograph (ECG) test
c) The presence of S4 Heart sound
d) Pain lasts for less than 5 minutes in an MI
Rationale
The correct answer is A because serum levels of cardiac biomarkers such as troponin and CK-MB are used for the final diagnosis of Myocardial infarction (STEMI, NSTEMI). Electrocardiograph (ECG) testing is used to distinguish between acute coronary syndromes with ST elevation on the ECG (STEMI) and those without an ST elevation on the ECG (Non St elevation and NSTEMI). The presence of S4 Heart sound may be indicative of myocardial ischemia due to the lack of oxygen supply to the heart muscle cells, also, it may be present in both MI and unstable angina hence can not be used to distinguish diagnosis. Pain duration is not very specific for diagnosis of ACS
2)
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During treatment of acute myocardial ischemia which of the following intervention may be effective in preserving myocardial muscle mass?
a) Decreasing myocardial oxygen demand
b) Decreasing myocardial oxygen supply
c) Increasing myocardial oxygen demand
d) Increasing myocardial oxygen supply
Rationale
The answers are A&D. Decreasing myocardial oxygen demand (heart rate control, preload/after load reduction) and Increasing myocardial oxygen supply (perfusion) are essential in the treatment of MI.
3) Which of the following is NOT part of ECG Changes that is associated with MI?
a) ST elevation
b) Inverted T wave
c) Shortened PR wave length
d) Abnormally deep or wide Q
wave Rationale Answer is C. Shortened PR wave is not a characteristic ECG change associated with MI. ST elevation, an inverted T wave, and abnormally deep or wide Q wave are all typical ECG changes associated with MI. 4) Which serum biomarker is most specific for early Diagnoses of MI a) Myoglobin b) CK-MB c) LDH d) Troponin I Rationale Answers are B &D. CK-MB (MB band of Creatine Kinase) and Troponin I are the most specific serum biomarkers for early diagnosis of acute myocardial infarction. LDH also aids in the diagnosis of MI, however, elevated serum levels occur after 72 hours. And also because LDH remains elevated for a long time, it is not used for early diagnosis of MI. Myoglobin levels are elevated in serum very quickly and are also used for early diagnosis but is less specific than the other markers. 5) A drop in cardiac output due to MI will result in all of the following compensatory response except? a) Increased heart rate b) Decreased blood pressure c) Fluid retention by the Kidney d) Vasoconstriction Rationale Answer is B. A decreased blood pressure is not part of the compensatory response. An increased heart rate, vasoconstriction and fluid retention by the kidney are all compensatory responses 6) Which type of infarction that usually involves necrosis of the entire thickness of the ventricles that is from the endocardium to the epicardium is? a) NSTEMI b) Aneurysm c) Subendocardial d) Transmural Rationale Answer is D. Transmural infarction involves necrosis of the entire thickness of the heart. Non ST elevation MI is a category of acute coronary syndrome that is characterized by no elevation of the ST segment on the electrocardiography, outcomes in NSTEMI are usually more severe than a STEMI. Aneurysm is an outpouching or dilation of the arterial walls that is most commonly found in the thoracic and abdominal aorta. Subendocardial refers to necrosis of the inner portions of the ventricle. 7) Which is NOT a complication associated with MI? a) Ventricular aneurysm b) Cardiogenic shock c) Bradycardia d) Mitral regurgitation Rationale Answer is C. Bradycardia is not a complication associated with MI rather tachycardia is a complication that occurs with MI. Vascular aneurysm, cardiogenic shock and mitral regurgitation are all complications associated with MI.
Cynthia Adae was taken to Clinton Memorial Hospital on June 28, 2006. She was taken to the hospital with back and chest pain. A doctor concluded that she was at high risk for acute coronary syndrome. She was transferred to the Clinton Memorial hospital emergency room. She reported to have pain for two or three weeks and that the pain started in her back or her chest. The pain sometimes increased with heavy breathing and sometimes radiated down her left arm. Cynthia said she had a high fever of 103 to 104 degrees. When she was in the emergency room her temperature was 99.3, she had a heart rate of 140, but her blood
There are several different heart problems that show up as an abnormal EKG reading. For example, a heart block can occur when there is a delay in the signals coming from the SA node, AV node, or the Purkinje fibers. However, clinically the term heart block is used to refer to an AV block. This delays or completely stops communication between the atria and the ventricles. AV block is shown on the EKG as a delayed or prolonged PR interval. The P wave represents the activity in the atria, and the QRS complex represents ventricular activity. This is why the PR interval shows the signal delay from the AV node. There are three degrees of severity, and if the delay is greater than .2 seconds it is classified as first degree. Second degree is classified by several regularly spaced P waves before each QRS complex. Third degree can be shown by P waves that have no spacing relationship to the QRS complex. Another type of blockage is bundle branch block. This is caused by a blockage in the bundle of His, creating a delay in the electrical signals traveling down the bundle branches to reach the ventricles. This results in a slowed heart beat, or brachycardia. On an EKG reading this is shown as a prolonged QRS complex. A normal QRS is about .8-.12 seconds, and anything longer is considered bundle branch block. Another type of abnormal EKG reading is atrial fibrillation, when the atria contracts very quickly. On the EKG this is shown by no clear P waves, only many small fibrillating waves, and no PR interval to measure. This results in a rapid and irregular heartbeat. On the other hand, ventricular fibrillation is much more serious and can cause sudden death if not treated by electrical defibrillation.
759. Mr. Miller is likely presenting with an acute myocardial infarction. Based on his past medical history of hypertension, hyperlipidemia, obesity, and diabetes, along with his current symptoms of chest pain, shortness of breath, pale skin with beads of sweat on the forehead, as well as elevated lab 's Troponin, CK, and CK-MB, he is most likely presenting with an acute myocardial infarction.
In this lab, I took two recordings of my heart using an electrocardiogram. An electrocardiogram, EKG pg. 628 Y and pg. 688 D, is a recording of the heart's electrical impulses, action potentials, going through the heart. The different phases of the EKG are referred to as waves; the P wave, QRS Complex, and the T wave. These waves each signify the different things that are occurring in the heart. For example, the P wave occurs when the sinoatrial (SA) node, aka the pacemaker, fires an action potential. This causes the atria, which is currently full of blood, to depolarize and to contract, aka atrial systole. The signal travels from the SA node to the atrioventricular (AV) node during the P-Q segment of the EKG. The AV node purposefully delays
The purpose for the stent was to hold the coronary artery open to allow the blood to flow more freely.
Vicki is a 42-year-old African American woman who was diagnosed with Hypertension a month ago. She has been married to her high school sweetheart for the past 20 years. She is self-employed and runs a successful insurance agency. Her work requires frequent travel and Vicki often has to eat at fast food restaurants for most of her meals. A poor diet that is high in salt and fat and low in nutrients for the body and stress from her job are contributing factors of Vicki’s diagnosis of hypertension. This paper will discuss the diagnostic testing, Complementary and Alternative Medicine treatments, the prognosis for hypertension, appropriate treatment for Vicki, patient education, and potential barriers to therapy that Vicki may experience.
An artery is an elastic blood vessel that transports blood away from the heart. There are two main types of arteries: pulmonary arteries and systemic arteries.
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P wave and an irregular QRS complex (Ignatavicius & Workman, 2013). Basically, it means that the atria, the upper chambers of the heart, are contracting too quickly and no clear P wave is identified because of this ‘fibrillation’ (Ignatavicius & Workman, 2013).
My clinical rotation for NURN 236 is unique in that all patients I care for at Union Memorial Hospital in Baltimore, Maryland have a diagnosis of heart failure (HF). HF occurs when the heart is unable to pump adequate blood supply, resulting in insufficient oxygen and nutrients to the tissues of the body (Smeltzer, Bare, Hinkle, and Cheever, 2012). Approximately 670,000 Americans are diagnosed with HF each year and is the most common hospital discharge diagnosis among the elderly (Simpson, 2014). Moreover, according to the Centers for Medicare and Medicaid Services (CMS), HF is the leading cause of 30-day hospital readmission followed by acute myocardial infarction (AMI) and pneumonia (medicare.gov|Hospital Compare, 2013).
This assignment is a case study that aims to explore the biospychosocial impacts of a myocardial infarction on a service user. It will focus on the interventions used by healthcare professionals throughout the patient’s journey to recovery. To abide by the NMC’s code of conduct (2015) which states that all nurses owe a duty of confidentiality to all those who are receiving care, the service user used in this case study will be referred to as Julie. Julie is a 67 year old lady who was rushed to her local accident and emergency following an episode of acute chest pain and was suspected to have suffered from a myocardial infarction. Julie who lives alone reported she had been experiencing shortness of breath and
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
Although in many occasion of heart palpitation, there can be sign of a serious, chronic underlying problem which may be like:
Heart/Peripheral Vascular: RRR, S1S2 at the apex, no S2S3 or murmurs heard on auscultation. Bilateral lower extremity edema. Capillary refills < 3sec, pink nail beds, radial and dorsalis pedis pulses palpate equal bilaterally.
Oxygen was first admitted to the client with chest pain over 100 years ago (Metcalfe, 2011). Chest pain is a large bracket that can contain many different conditions, but for the purpose of this analysis it is focused manly upon a myocardial infarction. A myocardial infarction is mainly referred to as a heart attack, and occurs when one or more coronary arteries leading to the heart reduce or completely stop blood flow (Tuipulotu, 2013 ). Administering high concentrations of oxygen to patients with chest pain is now embedded in guidelines, protocols and care pathways, even with a lack of clear supporting evidence (Nicholson, 2004 ). High concentration of oxygen means that up to 60% is administered (Knott, 2012). More recent research has suggested that the use of oxygen in this scenario is unnecessary and can lead to unwanted side effects, especially in normoxic cardiac patients (Moradkham & Sinoway, 2010 ). The aim of this comparative analysis is to dismantle and understand both the benefits and risks of the commonly known practice of administration of oxygen to the client with chest pain. Through completing this analysis using recent and appropriate evidence a more improved practice can be given and understood.
So, what really is cardiovascular drift and is it something to be worried about? Cardiovascular drift is an increase in heart rate that occurs when an athlete is doing the same amount of work and the same exact exercise. This is usually an occurrence when an athlete sweats. Sweating decreases the amount of plasma which means the heart must work harder to pump the oxygen rich blood throughout the body to the working muscles. On a day that’s hot, sweating is more common. Part of that sweat coming out of your body is to cool you off so that your core temperature, or the temperature of the inner part of your body, stays stable. This comes from the liquid portion of the blood, plasma.