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Related Concept Videos

Introduction Cardiac Emergencies01:30

Introduction Cardiac Emergencies

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Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
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Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

279
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
279
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

54
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
54
Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

261
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
261
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

90
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
90
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

113
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
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Orthopaedic cardiac considerations in emergency.

Spyridon Katsanos1, Theodosis Saranteas2, Andreas F Mavrogenis3

  • 1Department of Emergency Medicine and Cardiology, National and Kapodistrian University of Athens, 11527 Athens, Greece.

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Summary

Emergency orthopaedic surgery patients need cardiac evaluation only if symptomatic or if intervention lowers risk. Preoperative delays increase mortality, highlighting the need for clear cardiac assessment guidelines in orthopaedic surgery.

Keywords:
AnesthesiaAortic stenosisCardiologyEchocardiogramEmergencyOrthopaedic surgeryUltrasonography

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Area of Science:

  • Cardiology
  • Orthopaedic Surgery
  • Perioperative Medicine

Background:

  • Cardiac evaluation for emergency orthopaedic surgery patients is often debated.
  • Preoperative delays (24-48 hours) in emergency orthopaedic operations are linked to higher mortality and worse patient outcomes.
  • Current research is predominantly retrospective due to ethical and practical challenges in randomized controlled trials.

Discussion:

  • This editorial examines common cardiology challenges in emergency orthopaedic surgery.
  • It explores controversies surrounding existing recommendations for preoperative cardiac assessment.
  • The role of echocardiography in the perioperative management of these patients is discussed.

Key Insights:

  • Cardiac referral for emergency orthopaedic surgery patients should be selective, based on symptoms or expected benefit from cardiac intervention.
  • Minimizing preoperative delays is crucial to avoid adverse outcomes.
  • Evidence-based guidelines for preoperative cardiac care in this setting are often lacking or unclear.

Outlook:

  • Further research is needed to clarify the optimal use of cardiac evaluation and echocardiography in emergency orthopaedic surgery.
  • Development of more robust, evidence-based guidelines is essential for improved patient care.
  • Standardizing perioperative cardiac assessment protocols could enhance patient safety and functional status.