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Conditions that can beconsidered ABC

Heart failure & Dysrhythmias


Respiratory Failures & AcuteRespiratory Distress Syndrome
Renal Failure & End Stage RenalDisease
Burns

Coronary Artery Disease &Acute Coronary Syndromes
Most Common cause of cardiovascular disability and death.
It refers to a spectrum of illnessesthat range from the least lifethreatening to the most
lifethreatening acute coronarysyndrome(AMI/ Heart attack).
Incomplete occlusion of the coronary arterieslead to Angina (ischemia)
Complete occlusion of the coronary arterieslead to Myocardial Infarction
The heart will pump harder to meet the O2demand leading to Congestive Heart Failure.

Non Modifiable Risk Factors of CAD/ ACS
Age
Gender
Race
Heredity

Modifiable Risk Factors of CAD/ACS
Stress
Diet
Exercise
Cigarette Smoking
Alcohol
Hypertension
Hyperlipidimia
Diabetes Mellitus
Obesity
Personality Type or BehavioralFactors
Contraceptive Pills

Cardiovascular Assessment
Chest Pain
Most common
Due to Ischemia or MI
Precipitated by stress or can be relieved by Nitroglycerin (NTG)
In MI, it is more intense, unrelated to activities andcant be relieved by NTG
If it occurs during breathing, suspect respiratory problems

Cardiovascular Assessment
Dyspnea
subjective feeling (inability to get enough air).
Dyspnea on exertion is due to increased O2myocardial demand.
Orthopnea is related to blood pooling in the pulmonary bed; suspect Pulmonary Edema
Any sudden or acute dyspnea may be a sign of Pulmonary Embolism

Cardiovascular Assessment
Cough/sputum
Mucoid and foamy sputum can be a sign of CHF
Pink-tinged frothy appearance may signal PulmonaryEdema.
Whitish, viral infection
Change in color other than the above mentioned maysignify bacterial infection.

Cyanosis
Bluish discoloration of the skin and mucousmembrane
Sat O2 is below 90%
Fatigue
May be due to Anemias or related to decreasedCardiac Output

Palpitations
Awareness of rapid or irregular heart beat
Autonomic Nervous System and Adrenal Glandsresponse (stress)
Syncope
Transient loss of consciousness
Due to decreased cerebral tissue perfusion
Edema
Due to: Increased Hydrostatic Pressure (HP)
Decreased Colloidal OncoticPressure (COP)
Obstructed Lymphatic or Vascular System
Related to Inflammatory reaction
Types of Edema
Bilateral edema
=CHF or Renal Failure
Unilateral edema
=Vascular or Lymphatic obstruction
Non-pitting edema
=Inflammatory
Pitting edema
=HP and
COP derangement

Skin
Color, temperature, hair growth, nails,capillary refill
spooning of fingers /clubbing of fingers

Heart rate 60-100
Rhythm regular or irregular
Bruits and Thrills murmurlike; vascular inorigin- palpate a thrill, auscultate a bruit
Blood Pressure
Jugular venous pressure

Laboratory & Diagnostic Test
Complete Blood Count-
RBC suggest tissueoxygenation.Elevated WBC may indicate infectious heartdisease and MI.
Erythrocyte Sedimentation Rate (ESR )- Itsis elevated in infectious heart disorder or MI. Normal
range: Males: 15-20mm/hr Females: 20-30 mm/hr