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Acute Myocardial Infarction - Answers

1. Jason was slumped over, had difficulty breathing, and was perspiring excessively. He also had pain in his chest, neck, and arm.

2. Initial Assessment: Take vitals, perform EKG, check O2 level (O2 Saturation), start I.V., take a brief history, and draw blood for cardiac markers, serum electrolytes, and coagulation studies.

3. Treatment: Give oxygen, aspirin, nitroglycerin, and morphine if needed.

4. Lifestyle risks: overweight, stress, smoker, poor diet, little exercise.

5. Atria

6. Ventricles

7. Tricuspid (also called right atrioventricular valve)

8. Mitral (also called bicuspid or left atrioventricular valve)

9. Pulmonic (Pulmonary semilunar valve)

10. Aortic (Aortic semilunar valve)

11. Superior and inferior vena cava, right atrium, tricuspid valve (right AV), right ventricle, pulmonary valve, pulmonary trunk, right and left pulmonary arteries, right and left pulmonary veins, left atrium, mitral valve (bicuspid, left AV), left ventricle, aortic semilunar, aorta

12. Arteries carry blood away from the heart. Veins carry blood towards the heart. Capillaries connect arteries to veins.

13. A sphygmomanometer is used to measure blood pressure. A cuff is placed around the upper arm. A stethoscope is placed over the artery just below the cuff. The cuff is filled with air blocking off blood flow through the artery. As the air is slowly let out of the cuff. The first beat heard is the systolic pressure of the heart. The last beat heard is the diastolic pressure of the heart.

14. The systolic pressure is the pressure of the heart beating putting pressure on blood in the arteries. The diastolic pressure is the pressure exerted when the heart relaxes. The first pulse heard when taking a blood pressure represents the systolic pressure. The last pulse heard represents the diastolic pressure.

15. Movement of blood from the heart, to the lungs, and back to the heart again.

16. Movement of blood through the tissues of the heart, supplying oxygen and nutrients to heart cells.

17. Movement of blood through the heart, lungs, and blood vessels. The circulatory system includes the pulmonary circulation, coronary circulation, and systemic circulation.

18. Ultrasound of the heart. An ultrasound sends sound waves into the heart. The echoes of those waves are recorded.

19. Transthoracic echocardiogram (TTE). Views of the heart are obtained by moving the transducer to different locations on the chest or abdominal wall. Most common type.

Stress Echocardiogram. An echocardiogram is done before or after exercise to find out if there is decreased blood flow to the heart.
Doppler echocardiogram. An ultrasound computer uses the echoes of the sound waves to measure the direction and speed of blood flow through the heart and blood vessels. Images may be displayed in color or black and white.
Transesophageal echocardiogram (TEE). The transducer is passed down the esophagus which shows clearer pictures of the heart because there is no blockage from the lungs or ribs.

20. Recording of all of the action potentials of the heart. An electrocardiogram checks the electrical activity of the heart.

21. SA node

22. Sa node, AV node, AV Bundle (Bundle of HIS), Right and Left bundle branches, Purkinje fibers

23. Atrial depolarization.

24. At the end of the P wave

25. Ventricular depolarization

26. Ventricular contraction (ventricular systole)

27. Ventricular repolarization

28. Cardiac enzymes are elevated following a myocardial infarction because they are released from the damaged heart muscle.

29. Most cardiac enzymes do not peak until several hours following an M.I. (See link for cardiac enzymes).

30. Medical Laboratory Scientist

31. Troponin

32. Blockage of coronary artery results in loss of blood supply and oxygen to tissue of the heart. This can quickly damage and kill heart tissue.

33. Chest pain
Pain that may spread to the back, arms, neck, and jaw
Shortness of breath
Nausea, vomiting,
Rapid or irregular heartbeats
May also have other symptoms including weakness, anxiety, indigestion, and heartburn

34. Predominant symptoms may be heartburn, malaise (weakness or discomfort), heartbeat abnormalities, cough, and loss of appetite.

35. Plaque narrows or partially obstructs coronary arteries. May cause angina (chest pain)

36. Blood clot formation

37. Beta blockers slow the heart rate decreasing the strain on the heart and its need for oxygen. Streptokinase helps dissolve blood clots. Aspirin decreases further blood clot formation.

38. An angiogram is an x-ray picture of dye moving through coronary arteries. The dye is inserted into a catheter which is placed inside the heart.

39. An angiogram is done:

  • To make a definitive diagnosis of blocked arteries when other clinical information and tests are equivocal.
  • To determine if the blockages in the arteries are severe enough to be responsible for any symptoms the patient may be having.
  • To determine if a patient's blockages would be best treated by procedures such as an angioplasty or bypass surgery.
  • To assess the risk of future heart attacks in patients who have already had a heart attack or damage to their heart muscle.

40. Cardiovascular technologist.

41. The opening of a blocked coronary artery with a stent or balloon.

42. Femoral

43. An artery or vein from the body is connected to either side of the blocked coronary artery so that blood bypasses the blockage.

44. To decrease the metabolism to protect the brain and the heart.