Increased Cardiac Output

12 Lead Electrocardiogram (ECG) - There are typical changes to the normal pattern of the ECG in a heart attack. Patterns that occur include pathological Q waves and ST elevation (Koutoukidis, Stainton & Hughson 2013, p. 505). However, it is possible to have a normal ECG even if a patient has had a heart attack. The indicators for this test include: suspected myocardial infarction, suspected pulmonary embolism, perceived cardiac dysrhythmias, fainting or collapse, a third heart sound, fourth heart sound, a cardiac murmur or other findings to indicate structural heart disease. The

patient is able to understand what is going on which makes them more comfortable during

Within 1 hour of chest pain onset, the patient will: Display vital signs within normal limits and display normal depth and rate of respirations

Chest x-ray: an x-ray of the chest cavity, heart and lungs including all the arteries, ribs and diaphragm this test may be used to diagnose problems with the size or shape of the heart and if there is any problems with the position and shape of the large arteries it could also detect problems with the lungs eg. Cancers, fluid masses, a lung collapse and scaring.

Reviewing this data, the nurse can get more subjective data from the patient if they would to ask specific questions to obtain a complete health history like, when did the pain start? Does it hurt more if you touch it? Does this type of pain usually occur? How often does the pain occur? Where exactly on your chest does the pain occur? Is the pain superficial or deep? Does the pain feel like it is dull, sharp, or throbbing? On a scale of one to ten how would you rate your pain? What were you doing at the time the pain started? You say you have not eaten much today, but can you please tell me what you did eat? What was the list of foods you ate in the last 24 hours?

Coronary artery disease (CAD) is the leading cause of morbidity and one of the top killers among adults in industrialized countries. It accounts for approximately 600,000 deaths in the United States every year. 1,2 CAD can present itself in different ways, from chest pain during exercise (“angina”) to the most dreaded complication of heart disease, acute heart attack and sudden death.3 Identifying patients with CAD in daily clinical practice represents a challenging task. Accurate diagnosis and sufficient assessment of both symptomatic and asymptomatic patients with suspected CAD may show an essential impact on mortality rates and thus, it is of substantial interest.1 One method used to identify patients with myocardial ischemia due to CAD and those at high risk of future heart attacks is cardiac stress testing.

However for proper patients managements, clinical diagnoses is foremost step but it has its limitations. So there is need for additional tools to aid clinical evaluation and to their ability to identify the patient at possibility for cardiovascular diseases, as proposed by a recent National Institutes of Health (NIH) panel (Naghavi et al., 2003). Blood tests have been used for the indication of either disease or a future risk of the development of a disease over approximately 50 years. Blood tests help in detecting substances that are not present in normal physiological condition or check that elevated levels of substances from normal that indicate risk of disease. Electrocardiograms are used in the assessment of patients with chest discomfort,

Further, we would recommend to the patient to have an electrocardiogram (ECG) test, in order to be sure that the pain is not a cause of any heart-related problems. We would also recommend the patient perform basic physical exercises, as this would be helpful to relieve them of anxiety and panic (Richardson, 2012). The patient’s caretaker should monitor him carefully and contact the health care center if he displays any sudden condition of anxiety or panic attack.

SAMPLE is a popular acronym among many prehospital providers to quickly gain information about the patient. The SAMPLE acronym stands for: Signs/Symptoms, Allergies, Medications, Past medical history, Last intake/output, and Events leading up to the signs and symptoms. With every patient, it is very important to investigate the pain that is being experienced while the patient is in the prehospital providers care. The acronym used for the investigation of pain is OPQRST which stands for: Onset (events prior to when the pain started), Provocation (does anything make it better or worse), Quality (description of the pain), Radiation (does the pain radiate anywhere), Severity (usually the 1-10 scale is used to determine how bad the pain is) and Time (how long the pain has been present). The most important thing to remember is that everyone experiences things differently and that no every patient that has an inferior MI will present the same. It is important to investigate the chest pain when it is present. With cardiac chest pain the sensation is usually non-reproducible (Page, 12- Lead ECG for Acute and Critical Care Providers), which is crucial to the complete assessment of the

These can alert a nurse if the patient is at risk for heart problems. “Cardiovascular disease is the leading cause of death and major cause of disability in the United States” (Wilson 233). If a patient seeks a medical check-up due to chest pain, difficult breathing, extreme tiredness, pain in the lower extremities or cramping, collecting all the subjective data is necessary. After collecting the subjective data the nurse must also collect the objective data. Listening to the heart, taking their blood pressure can help with the diagnostic process.If a nurse is able to detect any abnormalities a patient has a higher chance of living a longer

A conceptual definition was used to define the meaning of symptoms related to the study. Based on this definition, a list of descriptive words that could describe the intensity, location, nature, and quality of symptoms experienced throughout the patient’s AMI were used in the form of an Experience of Heart Attack Symptoms questionnaire (EHAS). The Experience of Heart Attack Symptoms questionnaire was stated to be a modification of the Representation of Heart Attack Symptoms

Location: If the patient is experiencing pain, where does he feel the pain? Does he feel sinus pressure? Does he have body aches? Does he have chest pain?

Recording an electrocardiogram or ECG, is a procedure which is performed daily all over the United Kingdom by thousands of healthcare workers and in particular nurses (Jacobson, 2000). The way in which this procedure is performed varies from geographical location to location and occasionally even more so, between staff on the same ward (Amos, 2000). This reason stated by Amos (2000), formed the basis of my decision to choose this topic.

The paramedic will interpret the EKG and other vitals to make a determination of the appropriate intervention based on a set of predetermined criteria to reduce the pain and minimize the chance of the condition worsening. The emphasis for the paramedic is to treat the current symptoms and not concern themselves with the underlying issue as to why the patient may have developed chest pain.

Chest pain is a common presentation to Emergency department (ED) where the patients have extensive risk for death and other cardiac complexities such as cardiac arrest and acute heart failure (1). Coronary artery disease (CAD) is the most common cause of death, claiming 7.4 million lives in 2012 (2). Prompt identification, early intervention and appropriate disposition is possible with rapid and accurate risk stratification (3). The aim of this study is to determine the efficacy of using the Thrombolysis in Myocardial Infarction (TIMI) score as a risk stratification tool for patients presenting to ED with chest pain.