Percutaneous Coronary Intervention: A Case Study

- The goals of treatment include a decrease in ventricular response (to less than 100 beats/minute), prevention of stroke, and conversion to normal sinus rhythm, if possible. To accomplish this, I would expect the health care provider to initially order drugs to control the ventricular rate, such as calcium channel blockers, beta-adrenergic blockers, digoxin, and dronedarone. For some patients, pharmacologic or electrical conversion of the atrial fibrillation to normal sinus rhythm may then also be considered, such as by using amiodarone or electrical cardioversion. If the atrial fibrillation lasts for longer than 48 hours, anticoagulation therapy will be needed for 3-4 weeks before the cardioversion and for weeks after as well. If drugs or cardioversion do not work, radiofrequency catheter ablation and the Maze procedure would be expected as further options.

The right ventricle fills up  tricuspid valve closes  right ventricle contracts  pulmonary valve opens  the blood flows into the pulmonary artery  pulmonary valve closes  pulmonary artery splits into two vessels each going to the lungs.

Percutaneous coronary intervention (PCI) is an emergency treatment option for a patient experiencing MI. PCI can be performed within 90 minutes of arriving to the hospital. “Emergency diagnostic coronary angiography should be performed to identify blocked coronary artery before PCI” (Urden et al., 2014, p. 365).

A patient who becomes unresponsive may be experiencing arrhythmia. If a patient has fainted and there is no response immediately notify the physician also provide oxygen. loosen any tight clothing, cover the patient with a blanket for warmth. Once the emergency passes,obtain a set of vital signs and document all activities in the patient's medical

The client is stuporous on arrival to the emergency room and is in a medical emergency; you may or may not have time to administer pain medication. Preparing the chest tube set-up takes priority because your client is near death and this is what will reverse her grave situation. If you do have time after set-up or have other nurses helping you -- the quickest and fastest would be IV administration – it is a common order to administer morphine 2- 6 mg IV titrated (example: 2 mg at a time assessing each dose after approximately 5 minutes to see how the patient is doing; then giving 2 mg more, waiting, assessing; etc until pain relief is observed)

Call for help immediatly, than ask the patient question like , where is the pain coming from and how much pain is the patient is in.Observe the patient and hear the patient for his breathing.The patient can be having a heart attack or angina.If its angina they can take aspirin until help comes. Lay the patient down and make sure the patient is as comberable as possiable. Then keep checking the patients vitals signs til helps arrive. If patient becomes unconscious you will have to do CPR until help arrives ( Heller,2013).

General treatment could include making sure the individual is comfortable and warm, keeping his or her legs elevated above their head, administering appropriate medications if given authorization, and providing oxygen to the patient (Quick and Dirty Guide to Shock). Prevention is the best type of treatment. This means keeping a healthy lifestyle, and obtaining as much self-knowledge as possible.

These tests are called diagnostic tests. A 12 lead EKG is done to look at the electrical activity inside the heart. This EKG helps identify which areas of the heart may be damaged from the heart attack. Some medicines help stop blood clots from forming. They also keep existing clots from getting larger. Some drugs are known as clot busters. These drugs are given to dissolve clots that have already formed. Nitrates include the drug nitroglycerine. These medicines ease the coronary arteries and allow oxygen to reach the heart muscle. Nitrates also can reduce chest pain. Sometimes the patient is taken to an area of the called a step down unit. This unit will have different equipment and capably qualified doctors and nurses who provide the best current care

Cardiogenic shock is treated by identifying and treating the underlying cause. A patient with a heart attack may require a surgical procedure called a cardiac catheterization to unblock an artery. A patient with congestive heart failure may need medications to support and increase the force of the heart's beat. In severe cases, a heart transplant may be the only treatment.

The following summary is an updated case study of a 47 year old male patient, Jim who was diagnosed with Coronary Artery Disease. The patient did receive information on what CAD is and was informed that test were needed to fully diagnose and be evaluated for underlying conditions (high blood pressure, high blood cholesterol levels, diabetes and blockage. I will discuss the type of test needed for this condition and tests for any underlying conditions that are related to this disease. The type of treatment needed to control and lower his risk factor. I will also give the patient information about complementary and alternative medicine so the patient will be well informed about different types of treatment. The patient will be informed about the prognosis of the disease, and the options that the patient has to succeed in the changes in his lifestyle that are needed.

Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229)There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue,

Patients experiencing chest pain require immediate assessment, including a twelve lead ECG within the time frame of ten minutes, will provide vital evidence of a cardiac, plueretic or musculoskeletal event (Acute Coronary Care Clinical care standards 2014).

Coronary artery disease (CAD) is caused by fatty buildup in the arteries of the heart. Your arteries are made to carry oxygen infused blood to your heart and other parts of your body if it is filled up with plaque, which is the fatty substance that clogs and blocks up the arteries. If it gets clogged enough to where your heart is not receiving fresh oxygen, you could have a heart attack that could cause very serious damage to your body and could even kill you. When you are younger, you can begin to grow plaque in your blood vessels from not eating right and not exercising regularly. When your arteries are being filled up with plaque they become more narrow and harder for blood to get through as easily as it is supposed to be. When you have

When someone is possibly having a heart attack they should seek medical help immediately. They should call 9-1-1 and wait for paramedics to arrive. The patient should take their nitroglycerin and chew an aspirin if it is prescribed by a physician or a paramedic. Aspirin in the event of a heart attack will help the clot from forming more (Heart attack, 2011). If a patient is unconscious and it is suspected they are experiencing a heart attack bystanders should begin CPR until help arrives (Symptoms, 2013).

Percutaneous coronary intervention (PCI) is an invasive approach that improves clinical outcomes in clients with ST-segment elevation myocardial infarction (STEMI) and in clients with non-ST-segment elevation acute coronary syndromes (NSTEACS) (Mehta et al., 2012). Periprocedural major bleeding is a strong autonomous predictor of early and late major adverse cardiovascular events and mortality (Bernat et al., 2014). In an investigation of more than three million PCIs from the U. S. national registry, post-procedural bleeding events were linked with an increased chance of in-hospital mortality and an approximated 12.1% death rate related to bleeding complications (Bernat et al., 2014). In clients with acute coronary syndrome (ACS), access