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Cardiovascular System
Cardiovascular System
Cardiovascular conditions, evidence, coding, tests, medications, and related nursing diagnoses.
Major cardiovascular conditions
HF
Heart failure occurs when the heart cannot pump enough blood to meet the body's needs. Classified as HFrEF (EF <40%) or HFpEF (EF ≥50%).
ACS
ACS encompasses STEMI, NSTEMI, and unstable angina — all caused by reduced coronary blood flow, typically from plaque rupture.
STEMI
STEMI is a complete occlusion of a coronary artery causing transmural myocardial injury. Time-critical — goal is reperfusion within 90 minutes (PCI) or 30 minutes (thrombolytics).
NSTEMI
NSTEMI involves partial coronary artery occlusion with myocardial injury evidenced by elevated troponin without ST elevation. Managed with anticoagulation and early invasive strategy.
UA
Unstable angina is chest pain at rest or with minimal exertion without biomarker elevation. Part of ACS spectrum requiring urgent evaluation.
A-Fib
Atrial fibrillation is the most common sustained cardiac arrhythmia, characterized by disorganized atrial activity, irregularly irregular rhythm, and increased stroke risk.
A-Flutter
Atrial flutter is a reentrant supraventricular tachycardia with regular atrial activity at 250–350 bpm, typically with 2:1 or 4:1 AV block.
HTN
Hypertension (BP ≥130/80 mmHg per ACC/AHA 2017) is the most common cardiovascular risk factor, affecting ~50% of US adults.
DVT
DVT is a blood clot in a deep vein, typically in the legs. Major risk: pulmonary embolism. Virchow's triad — stasis, hypercoagulability, endothelial injury.
PE
Pulmonary embolism is obstruction of pulmonary vasculature, usually from DVT. Massive PE can cause obstructive shock and cardiac arrest. Risk stratified by hemodynamic stability.
PAD
PAD is atherosclerotic narrowing of peripheral arteries, typically lower extremities. Presents with claudication, rest pain, or non-healing wounds.
CS
Cardiogenic shock is circulatory failure from primary cardiac dysfunction. Criteria: SBP <90 mmHg, CI <2.2, PCWP >18. Most common cause is STEMI.
IE
Infective endocarditis is infection of the endocardial surface, typically heart valves. Diagnosed by Duke criteria. IV antibiotics 4–6 weeks; surgery in 50% of cases.
AS
Aortic stenosis is narrowing of the aortic valve. Severe AS defined as valve area <1.0 cm². Classic triad: angina, syncope, dyspnea. TAVR has transformed treatment.
MR
Mitral regurgitation is backflow through an incompetent mitral valve. Acute MR (papillary muscle rupture post-MI) is a surgical emergency. Chronic MR is often well tolerated.
Sinus Brady
Sinus bradycardia is a heart rate <60 bpm from the SA node. Often benign (athletes, sleep, vagal tone) but can be pathological. Treat if symptomatic.
Sinus Tachy
Sinus tachycardia (HR >100) is almost always a secondary response — treat the underlying cause (pain, fever, hypovolemia, anxiety, anemia, PE).
V-Tach
Ventricular tachycardia (≥3 consecutive PVCs at ≥100 bpm) can be pulseless (treat as cardiac arrest) or with pulse. Unstable VT requires synchronized cardioversion.
V-Fib
Ventricular fibrillation is chaotic, disorganized ventricular activity resulting in no cardiac output. A shockable rhythm — immediate defibrillation is life-saving.
Cardiac Arrest
Cardiac arrest is the cessation of cardiac mechanical activity. Rhythms: VF (shockable), pulseless VT (shockable), PEA, asystole. High-quality CPR and early defibrillation are critical.
AAA/TAA
Aortic aneurysm is dilation >50% of normal diameter. AAA (infrarenal aorta) is most common. Rupture is life-threatening. Repair at 5.5 cm (men) or 5.0 cm (women).
Aortic Dissection
Aortic dissection is a tear in the aortic intima allowing blood into the media. Type A (ascending aorta) — surgical emergency. Type B (descending) — medical management initially.
Tamponade
Cardiac tamponade is pericardial fluid accumulation causing cardiac compression. Beck's Triad: hypotension, JVD, muffled heart sounds. Pulsus paradoxus >10 mmHg. Emergency pericardiocentesis.
Pericarditis
Pericarditis is inflammation of the pericardium. Sharp pleuritic chest pain relieved by leaning forward. Most cases are viral/idiopathic. Treated with NSAIDs + colchicine.
Myocarditis
Myocarditis is inflammation of the myocardium, often viral (coxsackievirus, COVID-19). Ranges from mild (chest pain + troponin elevation) to fulminant heart failure.
DCM
Dilated cardiomyopathy is enlargement and impaired contraction of one or both ventricles. Most common cardiomyopathy. Causes: idiopathic, ischemic, alcoholic, peripartum, genetic.
HCM
HCM is asymmetric LV hypertrophy without a secondary cause. Most common genetic cardiac disorder (1:500). Leading cause of sudden cardiac death in young athletes.
OH
Orthostatic hypotension is a drop in SBP ≥20 or DBP ≥10 mmHg within 3 minutes of standing. Major fall risk in elderly. Causes: dehydration, medications, autonomic dysfunction.
Dyslipidemia
Hyperlipidemia is elevated blood lipids (LDL, triglycerides) or low HDL. Primary cardiovascular risk factor. Treatment based on 10-year ASCVD risk calculation.
Atherosclerosis
Atherosclerosis is chronic inflammatory plaque buildup in arterial walls leading to CAD, stroke, and PAD. Risk factors: hypertension, diabetes, smoking, hyperlipidemia, family history.
Pacemakers
Pacemakers deliver electrical stimuli to maintain adequate heart rate. Types: temporary (transcutaneous, transvenous) and permanent (single, dual, CRT, ICD). Nurses monitor for failure to capture, sense, and pace.
Related nursing diagnoses
Nursing Diagnoses & Care Plans
Open the NANDA tool to review nursing diagnoses and care-plan concepts related to cardiovascular conditions.