Symptoms
Due To Low Cardiac Output –
- Hypotension,
- Confusion,
- Convultion,
- Cold Clummy Skin,
- Oliguria,
- Uraemia.
Due To Pulmonary Oedema –
- Dyspnoea,
- Hypoxia,
- Cough With Frothy Expectoration.
Symptoms Due To Cause
- Chest Pain - Mi
Signs
General Examination –
- Anxious, Pale,
- Central Cyanosis May Be Present,
- Pulse=Tachycardia With Pulsus Alterance.
- Bp= Normal Or Increased.
Precordium-
- Apex Beat= Shifted Downwords Laterally Or Normal.
- Gallop Rythm.
- Loud 2nd Heart Sound.
Lungs - Bilateral Basal Crepitation, Cheyne Strokes Respiration.
Investigation.
Chest X Ray
- Enlarged Cardiac Silhouette,
- Hilar Congestion,
- Bilateral Hilar Opacity-Bat Wing Or Butterfly Shadow.
- Karley's B Line,
- Ground Glass Apperence Of Lung Fields,
- Plural Effussion.
ECG,
Echocardiography,
CBC,
Blood Urea And Serum Creatinine,
Serum Electrolytes,
Cardiac Enzymes.
General Treatment
Bed Rest.
- High Flow Oxigen.
- Iv Morphine 5mg.
- Inj Prochlorperazine.
- Iv Access By 5% Da.
Specific Treatment
- Diuretics - Frusemide And/Or Spironolactone.
- Vasodilators - Ace Inhibitor-Captopril, Enalapril. Prazosin, Hydralazine, Glycerine Tri Nitrate, Isosobride Dinitrate.
- Inotropic Drugs
- Cardiac Glycoside - Digoxin
- B Agonists - Dopamine, Dobutamine.
- Anticoagulant.
- Sublingual Nifedipine - If Required To Reduce Blood Pressure.
- Slow Iv Aminophyline 1amp Dissolved In 20ml Of 25% Glucose Over 10-15 Min If Associated Bronchospasm.
Monitoring
Input Output Chart.
Pulse, Temp, Bp, Blood Glucose.
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