Introduction:
The cardiorespiratory systems, the cardiac and respiratory systems, include the heart, blood vessels, lungs, and airways. The heart and lungs together help in the efficient transportation of blood across the body from the heart, along with the facilitation of oxygen and carbon dioxide exchange.
What Are the Most Common Cardiovascular Medical Emergencies?
Cardiovascular emergencies, if left untreated or unnoticed, can become life-threatening. So, a detailed assessment of the patient's history and condition is important. The first step in an emergency setting is to assess the airway, breathing, and circulation of the patient.
The most common medical emergencies pertaining to the cardiovascular system are as follows:
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Myocardial Infarction (MI): It is a cardiovascular emergency that is caused due to occlusion of one of the arteries and cardiac muscle becoming hypoxic (reduced oxygen supply). It is diagnosed through ECG (electrocardiogram). Patients complain of chest pain that radiates nausea, fatigue, dyspnea (shortness of breath), dizziness, diaphoresis, and anxiety.
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Angina Pectoris: It is caused when the arteries are partially occluded due to atherosclerotic damage or narrowing. Angina can be stable or unstable. Stable angina refers to a condition in which chest pain is elicited after a certain exertion. Unstable angina occurs when there may be no exertion, and it is often unpredictable. Unstable angina patients present to the emergency department with acute exacerbations of the symptom. Medication to dilate blood vessels, control heart rate and blood pressure, and blood thinners will be prescribed by the doctors.
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Pericarditis: Pericarditis is a condition in which the pericardium is inflamed. Pericardium is the fibrous sac surrounding the heart. It occurs due to infection in most cases. Pericarditis can complicate conditions like cardiac arrest or myocardial infarction. Patients usually experience non-specific infection symptoms, dyspnoea, and severe chest pain. Dysrhythmias are also evident. Supportive therapy like short-term sedation and aggressive antibiotic therapy is done to treat this if the infection is due to bacteria.
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Dysrhythmia: A cardiovascular emergency that is characterized by an abnormal heart rhythm. Common dysrhythmias include tachycardias and bradycardias. Tachycardia is a condition in which the heart rate is higher than 100 beats per minute, including atrial flutter, atrial or ventricular fibrillation, and long QT syndrome. Bradycardia refers to a condition in which the heart rate is lower than 60 beats per minute.
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Hypertensive Crisis: This is an emergency situation in which the patient's blood pressure is abnormally high, and there is a high risk of acute end-organ damage. The cause can be renal or endocrine dysfunction. Management of this condition necessitates close monitoring of patients along with managing complications like renal or liver failure.
What Are the Most Common Respiratory Medical Emergencies?
Respiratory emergencies can range from mild breathing difficulty to life-threatening conditions. Respiratory compromise can lead to respiratory failure if left unnoticed and untreated. Detailed assessment of the history and condition of the patients is essential. Some of the respiratory emergencies are:
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Pneumonia: Pneumonia is a bacterial infectious disease that is characterized by an acute inflammatory reaction in the lungs. There will be presenting symptoms like fatigue, fever, hemoptysis (coughing up with blood), dyspnea, and pleuritic chest pain. Crackles are evident on auscultation. Aggressive and immediate administration of broad-spectrum antibiotics is carried out in the emergency department. The causative bacteria is identified through blood cultures or sputum samples.
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Asthma: Asthma is a chronic lung disease in which there is hyper-reactive inflammation and airway narrowing. Patients with exacerbation will complain of severe dyspnoea, wheezing, coughing, tightness of the chest, and distress. Management includes oxygen administration along with inhaled beta-2 agonists, which will help improve air entry and relax the narrowed airways.
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Pneumothorax: Pneumothorax refers to the accumulation of air around the lungs in the pleural space resulting in lung collapse. It can be caused due to trauma, and there can be a spontaneous pneumothorax. Patients usually complain of chest pain, tachycardia, and dyspnea. On examination, there will be absent lung sounds in the affected or collapsed lung's side. Pneumothorax is managed by inserting a drain between the ribs to empty the pleural space. It is done in the emergency setting under local anesthesia.
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Pulmonary Embolism: Pulmonary embolism occurs due to the occlusion of blood vessels in the lungs, which is due to a blood clot or atherosclerotic plaque deposition. Patients present with worsening dyspnoea, cough, tachycardia, anxiety, and diaphoresis (excessive abnormal sweating). Diagnosing can be very challenging, and the physician orders a number of laboratory investigations, such as CT (computed tomography) scans, electrocardiography (ECG), ultrasonography, and ABG (arterial blood gas) analysis. Management is supportive therapy in which oxygen, intravenous fluids, and analgesics are administered to ease the symptoms. Antithrombotic therapy is carried out if the cause is a blood clot.
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Acute Bronchiolitis: It is a condition in which the bronchioles are severely inflamed due to viruses, most commonly. Affected individuals have symptoms of a cold or a viral infection, especially chest pain, severe cough, dyspnea, chest pain, and fatigue. Supportive therapy with medications and humidified oxygen administration is carried out to ease coughing.
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COPD (Chronic Obstructive Pulmonary Disease): COPD is an irreversible progressing disease with emphysema (alveoli enlargement) and bronchitis (bronchioles' inflammation). There can be severe dyspnea, purulent (pus-containing) sputum production, chest pain, and distress. Supportive therapy is carried out.
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Inhalational Injury: Inhalation injuries are caused due to inhalation of certain substances that can be toxic. These include hot gas in case of fire accident, including inhalation of smoke and carbon monoxide. Inhalation of water in a near drowning accident, and ingestion or inhalation of a foreign body. The patient may complain of a variety of non-specific symptoms, including coughing, dyspnoea, tachypnea, gagging, choking, and pleuritic chest pain. Intensive and invasive supportive therapies are carried out to manage patients with inhalation injuries.
Conclusion:
Cardiovascular and respiratory emergencies are the most common in the emergency care setting. Identifying the symptoms and swift intervention can reduce the incidence of potentially fatal complications like organ damage. The cardiorespiratory system effectively functions to provide circulation and remove waste products from all organs in the body. The harmony of the cardiorespiratory system can be disrupted by the aforementioned diseases. It is advised never to neglect a symptom and always seek the emergency department when there is any kind of difficulty.
