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CCRN/PCCN Review Course Cardiovascular: Oxygenation

CCRN/PCCN Review CourseCardiovascular: OxygenationTheresa Cary RN, MSN, ACNS-BC, CCRNC linical Nurse SpecialistCardiac Medical Step-DownThe author has no conflicts of interest to discloseDeterminants of Myocardial Oxygen Supply and DemandOxygen Supply Coronary Artery Anatomy Diastolic Pressure Diastolic Time Oxygen Extraction Hemoglobin PaO2 Oxygen Demand Heart Rate Afterload Preload ContractilityMyocardial oxygen consumptionCleveland ClinicAtherosclerosis Affects mainly large and medium-sized arteries Can begin in childhood and is progressive Stable plaque may narrow the lumen of the artery causing chronic ischemia (stable angina) Unstable plaque can rupture thrombus that partially or completely occludes the artery acute ischemia (unstable angina)Determinants of Myocardial Oxygen Supply and DemandOxygen Supply Coronary Artery Anatomy Diastolic Pressure Diastolic Time Oxygen Extraction Hemoglobin PaO2 Oxygen Demand Heart Rate Preload Afterload ContractilityMyocardial oxygen consumptionDiastolic Pressure The myocardium recei

Lateral Wall MI (ECG leads V5, V6, I, aVL) • Bradydysrhythmias • AV Blocks • LV dysfunction (HF symptoms) Cx Posterior Wall MI (reciprocal changes ECG leads V1 – V2 ST depression) • Usually an extension of Inferior or Lateral MI (RCA or Cx occlusion) • Bradydysrhythmias • May see RV involvement and papillary muscle RCA dysfunction Cx

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