La Insuficiencia Cardiaca ( Ic )

Apical hypertrophic cardiomyopathy is a disease that mainly affects the apex of the heart and does not cause any obstruction. [1] These abnormalities in the heart muscle can cause a wide variety of symptoms. As the heart becomes stiff it increases the pressure in the left ventricle which can push blood back into the lungs, causing shortness of breath in exercise. Chest pain can occur as there is not enough oxygen available to the cardiac muscle due to insufficient blood supply. Palpitations and lightheadedness, along with other conditions can occur as a result of HCM. In addition to these discomforting symptoms, the patient may develop an arrhythmias that often goes unnoticed. An arrhythmia takes place as the electrical conduction of the heart is disturbed by the abnormal scattering of myocytes. The two most common arrhythmias are atrial fibrillation causing palpitations, and ventricular tachycardia that can be life threatening causing sudden death. Both conditions can be controlled with medication. [4]

| |Coronary circulation |that pushes blood to the organs, |Abnormal heart rhythms or arrhythmias |

At this point, we do not know exactly what are the settings, we have previous requested pacemaker operative report from Regions. Unfortunately, from what he is telling today, his date of the birth was not correct as such dose report were not same. He noted that he thinks he came back from the hospital, he has not had similar complaint or concern or report of chest pain. It should be noted that hospital records, with a troponin that was negative, 12-lead EKG was similar to the one that was obtained here, essentially identifying sinus bradycardia with first-degree AV block, left ventricular hypertrophy with repolarization abnormality. QT was prolonged, similar EKG obtained at facility also identified pretty much the same abnormality pattern. Troponin was negative. Other workup included chest x-ray in the hospital were all unremarkable. Today he is not reporting any chest pain, no shortness of breath, no nausea or emesis. He has got healed ____ scar to the left chest from pacemaker implantation which is completely healed but slightly

TROPONINS – Markers of choice. Elevated between 4 and 6 hours after the onset of an acute MI and remains elevated for 8-12 days.

You are working in the internal medicine clinic of a large teaching hospital. Today your first patient is 70-year-old J.M, a man who has been coming to the clinic for several years for management of CAD and HTN. A cardiac catheterization done a year ago showed 50% stenosis of the circumflex coronary artery. He has had episodes of dizziness for the past 6 months and orthostatic hypotension, shoulder discomfort, and decreased exercise tolerance for the past 2 months. On his last clinic visit 3 weeks ago, a CXR showed cardiomegaly and a 12-lead ECG showed sinus tachycardia with left bundle branch block. You review his morning blood work and initial assessment.

R E V I E W S H E E T 30 Anatomy of the Heart

These stated facts very well implicate an imperative need to investigate promising alternative treatment strategies as well preventive measures. Impairment in cardiac functions, organ (heart) failure or trigger of compensatory mechanisms (hypertrophy, neurohumoral system activation, autokrine, paracrine stimulation, etc) are the result of loss in cardiac myocytes predominantly due to myocardial infarction (Zimmermann and Eschenhagen, 2003). In addition to the traditional treatment of

Due to numerous etiologies that will lead to cardiac arrest there is a potential for variable mortality reporting and therefore it is conceivable this number is misrepresented. A more accurate estimation of the burden of cardiac arrests can be elucidated from ROC data where the incidence of EMS-treated OHCA was found to be 73.0 individuals per 100,000 population (95% CI, 71.2–74.7) for adults and 7.3 per 100,000 population (95% CI, 6.3–8.3) for children <18 years old (heart disease and stroke). As compared to an overall incidence rate, individuals who have received treatment by EMS have the most potential for survival as this excludes arrest events where signs of obvious death were present, or a DNR was in place. An Oregon-based study extrapolated a national risk-adjusted incidence of sudden cardiac death, due to a cardiac etiology to be 60 per 100,000 population (95% CI, 54–66) with a premature death burden for men of 2.04 million (95% CI, 1.86 – 2.23 million) and women 1.29 million years of potential life lost (95% CI, 1.13 – 1.45 million). (https://www.ncbi.nlm.nih.gov/pubmed/24610738). The CARES data report from 2005-2010 provides insight into the demographics of OHCA due to cardiac etiologies and their survival rates (see table 1). Mean socioeconomic status of the region was found to be a significant indicator of increased incidence of sudden cardiac arrest, with a two- to fourfold greater incidence in regions in the lowest economic quartile compared to the highest quartile in the US among people less than 65 years old (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193117/). The previous studies do not allow for a complete representation of the mortality that results from cardiac arrest due to selective populations studied. There is a clear necessity for

According to the American Heart Association (2015), heart failure is defined as “a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload”. Congestive heart failure is a progressive illness that effects millions of Americans every year. Many other illnesses can lead to the development of congestive heart failure. Examples of these diseases include: coronary artery disease, past heart attack, high blood pressure, abnormal heart valve, heart muscle disease such as hypertrophic cardiomyopathy, dilated cardiomyopathy or inflammation such as myocarditis, congenital heart disease, severe lung disease, diabetes, obesity and asthma. (American Heart Association, 2015 (Centers for

43 percent of alarm conditions indicated non-critical, and “generally non-actionable,” events; 38 percent of alarm conditions indicated premature ventricular complexes (PVCs), which, since a landmark 1988 Cardiac Arrhythmic Suppression Trial (CAST) study, are no longer treated; and 3.6 percent of alarm

* D: Decreased cardiac output related to inflammation of lining of the heart and valves.

Some of the sources of power on this cardiac unit are positional and personal. Randall (2012) believes those who are in the position of power may influence others in shaping the climate in which they work. Randall explains the three positional powers are legitimate, reward, and coercive. The legitimate or positional power of the nurse manager, who has the power to structure their unit, so the organization’s mission, standards, and objectives are met by methods, such as mentoring programs and training. Randal believes reward power promotes productivity and interest in employees,’ such as providing time off, movie tickets, and extra pay for unscheduled shifts. Also, coercive power is considered disciplinary measures implemented by the nurse

The patient’s chart did not state which type of cardiomyopathy he had a history of, but there are four types of cardiomyopathies. Dilated cardiomyopathy is when both heart ventricles are dilated and the heart’s pumping function is impaired because the ventricular walls stretch out to very thin widths (Dechant, 2016). Hypertrophic cardiomyopathy is where the walls of the ventricles thicken and grow inwards, and could impair the outflow of blood when the heart contracts (Dechant, 2016). Restrictive cardiomyopathy is when the ventricles stiffen in elasticity, restricting the inflow of blood into the ventricles at rest (Dechant, 2016). Finally, arrhythmogenic right ventricular cardiomyopathy could involve either ventricle and is when the myocardial tissue is replaced by fatty tissue, impairing overall ventricular function (Dechant, 2016).

C.B. presented to the hospital and was quickly diagnosed with an acute MI, or heart attack. MIs are typically characterized by the death of the myocardial tissues due to a significant decrease in the supply of oxygen to the heart. The heart is composed of two primary systems: the pump and the electrical system. The heart’s electrical system is divided into three main components: the sinoatrial node in the right atrium, the atrioventricular node in the main septum close to the tricuspid valve, and the Perkinje fibers found on the walls of the ventricles. Important aspects of MIs are whether or not they are a STEMI or a NSTEMI, which is a non-ST-elevation myocardial infarction. STEMIs generally occur as a result of the complete blockage of an artery. NSTEMIs are considered less severe

The heart is one of the most important organs in an organism’s body, no matter if they are aquatic, amphibian, or a mammal. This super organ works automatically, able to pump massive amounts of oxygen rich blood through the body by means of electrical impulses and the opening and closing of valves within its many layers. It is what keeps us and every other creature on this earth alive; so it is only natural for one to fear when there might be a problem with one’s heart. A cardiac arrhythmia can happen to anyone, no matter the age, race, or gender, and as such, doctors and scientist have spent years trying to better understand the heart and the way it functions so that they can try to prevent these problems and save millions of lives.