An abdominal aortic aneurysm (often referred to as a ‘triple A’), is an abnormal dilation of the abdominal segment of the aorta. Smoking is a significant risk factor for development of this condition. As the aneurysm grows, there is an increased risk of rupture, which can be life threatening.
Acute coronary syndromes result from acute obstruction of a coronary artery. Consequences depend on degree and location of obstruction and range from unstable angina to non–ST-segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI), and sudden cardiac death.
Chest discomfort (+/- dyspnea), nausea, and diaphoresis.
ECG (ST-segment elevation/depression)
Initial treatment includes antiplatelets (aspirin and clopidogrel), pain control (nitroglycerin/morphine), anticoagulation (Heparin), beta-blocker (if no signs of heart failure), statin (high-dose atorvastatin).
The aorta is the largest blood vessel of the body and carries blood away from the heart. An aortic dissection occurs when the lining of the aorta begins to separate. Type A dissections move towards the heart and are a surgical emergency. Type B dissections move away from the heart and may be managed with medication to control blood pressure and heart rate.
“Ripping/tearing” sensation, asymmetric pulses/BP
CXR (show widened mediastinum). CT or transesophageal echo confirms diagnosis.
“Anti-impulse therapy”. Reduce BP and HR as low as tolerable using IV beta-blockers (ex. esmolol, labetalol) and nitroprusside (after HR controlled).
Broad disease characterized by inadequate blood flow to meet metabolic demands. Heart failure can be right-sided or left-sided. Left-side heart failure is further categorized into heart failure with reduced ejection fraction (HFrEF or “systolic failure) or heart failure with preserved ejection fraction (HFpEF or “diastolic failure”)
Largely depends on type of HF. Left-sided HF typically causes SOB, fatigue, orthopnea, rales/crackles on lung sounds. Right-side HF typically causes pitting edema, abdominal fluid accumulation, and JVD
Mostly clinical; BNP will be elevated, CXR may show cardiomegaly and effusions. Cardiac ultrasound is the most useful diagnostic tool.
Fluid overload and pulmonary edema can be managed with CPAP/BPAP, nitroglycerin, and furosemide. Hypotension can be managed with norepinephrine.