1. CARDIOVASCULAR SYSTEM EMERGENCIES

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

3. 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.

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

5. 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

6. 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

7. 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)

8. 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

9. 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.

10. 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.

11. 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.

12. 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.

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

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