Terri A. Donaldson – Complex Cardiac Emergencies: Assessment, Recognition and Management

Outline

1. Acute Coronary Syndrome (ACS)
   1. Unstable angina/NSTEMI
   2. STEMI
   3. Assessment of chest pain
      1. Atypical presentations
   4. Diagnosis of ACS
      1. Cardiac biomarkers
      2. Electrocardiographic changes
         1. Ischemia
         2. Injury
         3. Infarction
      3. Diagnostic studies
         1. Rest and stress imaging studies
         2. Stress testing
         3. Cardiac catheterization
         4. Coronary angiography
      4. Evidenced-based guidelines for management of ACS
      5. Pharmacologic management
      6. Reperfusion options
         1. Selection of strategies
         2. Pharmacologic reperfusion
         3. Percutaneous coronary intervention (PCI)
         4. Surgical reperfusion
      7. Ancillary therapy
2. Imposters and Variants
   1. 12-Lead ECG
      1. Early repolarization
      2. Hypertrophy
      3. Pericarditis
      4. Cor pulmonale
   2. Chest pain
   3. Pericarditis
   4. Pulmonary embolism
   5. Aortic dissection
   6. Management decisions
3. Complications of Myocardial Infarction
   1. Cardiogenic shock
      1. Hemodynamic parameters
      2. Pharmacogical management
      3. Mechanical assist devices
   2. Right ventricular infarction
      1. Clinical presentation and diagnosis
      2. Management strategies
   3. Mechanical complications and management strategies
      1. Ventricular septal defect
      2. Left ventricular free wall rupture
      3. Left ventricular aneurysm
      4. Papillary muscle rupture
4. Urgent/Emergent Cardiac Dysrhythmias
   1. Ventricular dysrhythmias
   2. Heart block
   3. Supraventricular rhythms
      1. Atrial tachycardia
      2. Atrial fibrillation/flutter
      3. Re-entry tachycardias
      4. Wolff-Parkinson-White
      5. Junctional tachycardia
   4. Management approaches
5. Cardiac Tamponade
   1. Etiology
   2. Clinical presentation
   3. Physical exam findings
   4. Diagnosis and management
6. What’s on the Horizon for Cardiac Nursing?