CARDIOVASCULAR SYSTEM EMERGENCIES

MYOCARDIAL INFARCTION Obstruction of the coronary artery resulting into death of heart muscles due to lack of blood supply . Also called heart attack

Commonest cause is rupture of an atherosclerotic plaque in the coronary artery followed by arterial spasms and subsequent embolus formation Severity depends on level and duration of arterial occlusion.

RISK FACTORS Increasing age Male gender Smoking Obesity Hypercholesterolemia diabetes mellitus Poorly controlled hypertension Sedentary lifestyle Psychosocial stress vasculitis

SIGNS AND SYMPTOMS Tightness in the chest Sudden crushing pain in the centre of the chest which spreads to the arms, back, throat. Pain does not ease with rest Profuse sweating Weakness Cyanosis Extreme gasping Abdominal discomfort Sudden faintness /dizziness

signs Breathlessness Fast pulse which becomes weaker and may become irregular. Signs and symptoms of shock Unconsciousness Breathing and heart beat may stop. Feeling of impending doom

Treatment Aspirin can be used to limit extent of damage to the heart muscle. Encourage rest to reduce oxygen demand of the heart Ensure comfort by positioning casualty in half sitting up position, head and shoulders supported and knees bent ,place cushions behind him and under his knees.( conscious pt)

treatment Call 999 for help/ or personal doctor Include 3 Ws details- who ,what, where Assist casualty to take a full dose of aspirin- 300 mg and chew slowly If the casualty has angina medication let him administer it Avoid undue stress by staying calm

Treatment Loosen any tight clothing around the neck Unconscious patient should be placed in the recovery position. Start C.P.R if the heart and breathing has stopped. urgently Shift the patient to hospital as a stretcher case in the recovery position.

ANGINA PECTORIS This condition occurs when the coronary arteries become very narrow so that supply of oxygenated blood to the heart muscle is decreased. Occurs in elderly patients Precipitated by over exertion and excitement Attacks last for few minutes and the pain subsides with rest.

Signs and Symptoms Chest pain spreading down the left shoulder to the arms and fingers. Breathlessness General weakness Skin may be ashen, lips may be blue. Anxiety Pain easing with rest.

Treatment Help the casualty to sit down, reassure the casualty and allow him to rest. Loosen the clothes around the waist, neck, chest. If the casualty has Glyceryl trinitrate, advice him to place it under the tongue. If symptoms persist, then arrange to send him to hospital immediately If casualty becomes unconscious, manage as unconscious. Call for help. CPR.

MYOCARDIAL INFARCTION VS. ANGINA PECTORIS ANGINA PESTORIS M.INFARCTION Pain substernal substernal Radiation neck,jaw,arm same Duration 3 to 8 mins > 30 mins Other none sweating. nausea Symptoms weakness,cyanosis. Precipitating factor: exertion none stress, meals Relieving factors: rest, nitoglycerin none

RISK FACTORS FOR CARDIO VASCULAR DISEASES Tobacco smoking Diabetes High blood pressure Sedentary lifestyle Obesity Stress Alcohol Family history of premature heart disease