Cardiorespiratory Arrest

coronary arteries. Dissection can be seen in connective tissue diseases, fibromuscular dysplasia, and pregnancy.

The symptoms depend on the size and location of the obstruction. Pain is described as the urge to burp, discomfort, tearing pain, indigestion, pressure, burning, sharp, or stabbing. The degree of pain does not predict the size of the infarct. Complications you need to look out for include cardiac arrhythmias or conduction defects, heart failure, septal rupture, ventricular aneurysm, mural thrombosis, shock, valve dysfunction, and later, Dressler syndrome, which is post-MI pericarditis.

Because the diagnosis is not always clear, serial enzymes and serial ECGs are necessary. The patient with a STEMI or evidence of ongoing pain, hypotension, or unstable arrhythmias should have immediate angiography. This can be delayed for a day or two In NSTEMI or unstable angina patients. The ECG is the most important diagnostic test for an MI. Cardiac makers include troponin T, myoglobin, troponin I, and CK-MB. Angiography is confirmatory and is paired with percutaneous coronary intervention, if necessary.

All patients need aspirin, nitrates, and oxygen in the prehospital setting. In the ED, consider morphine for pain and dyspnea, antiplatelet drugs, anticoagulants, reperfusion drugs like TPA, and percutaneous intervention. Some patients will need coronary artery bypass surgery.

CARDIORESPIRATORY ARREST

Cardiac arrest involves the lack of a perfusing rhythm such that organs are not perfused and death rapidly ensues. There is often little warning or no warning involved in the event, with nearly 90 percent of people dying of this type of event. There are distinct differences between a respiratory arrest and a cardiac arrest, although one generally leads quickly to the other.

Almost all adults with an arrest will have a cardiac arrest first from some type of cardiac disease. Other causes include a major hemorrhage, traumatic event, or pulmonary embolism. Metabolic disturbances can rarely be a cause, including a drug overdose, leading to respiratory arrest. Infants and children have respiratory arrest first, due to