• Fri. Oct 7th, 2022

Cardiovascular Collapse | Etiology | Treatment | QuadBloggers

cardiovascular collapse

Cardiovascular collapse is a condition caused due:

  • Severe hypotension from acute dysfunction of the heart or
  • Peripheral vasculature causing hypotension with resulting cerebral hypoperfusion
  • Loss of consciousness that can be a result of severe myocardial dysfunction and cardiac arrhythmias
  • Furthermore, immediate institution of cardiopulmonary resuscitation needs employment.
  • Followed by advanced life support measures.
  • Ventricular fibrillation is fatal, if CPR assessment fails.
cardiovascular collapse

Causes:

  • A) Coronary artery disease ( Acute or chronic )
  • B) Inflammatory conditions ( Myopathies )
  • C) Valvular heart diseases ( aortic stenosis, mitral valve prolapse )
  • D) Cardiomyopathies ( dilated or hypertrophic )
  • E) Electrophysiologic abnormalities ( Wolff-Parkinson-White syndrome )
  • F) Inherited disorders associated with electrophysiological abnormalities like Brugada syndrome and congenital long QT syndrome.
  • G) Functional Contributing Factors:
    • Transient ischemia
    • Low cardiac output states
    • Electrolyte imbalance
    • Hypoxemia
    • Cardiac toxins
  • H) Pulseless electrical activity,hence leading to sudden death:
    • Massive pulmonary embolism
    • Tension pneumothorax
    • Cardiac tamponade

Management of cardiac arrest:

  • Retrieve automated external defibrillator
  • Phone emergency line
  • On the contrary, aspiration of a foreign body and performing Heimlich maneuver, if respiratory stridor is present, is also considered important.
  • Chest compressions performed at the rate of 100 to 140 beats/min without any interruptions while the Second personal should be ready with the defibrillator.
  • Trained second personal should:
    • Tilt the patients head backward, lift the chin and start rescue breathing while the chest compressions continue .
  • Furthermore, lung inflation, done twice in rapid succession for every 30 compressions.
  • As soon as resuscitation equipment is available , begin advanced life support with continued chest compressions and ventilation.
  • Establishment of IV access and hence use of advanced airway like endotracheal tube with 100 % oxygen should be administered.
  • Additionally, initial IV access via antecubital vein or central like via internal jugular vein is important.
  • Moreover, IV sodium bicarbonate started if severe acidosis is present.
  • Therapeutic hypothermia, considered for unconscious survivors of cardiac arrest.

Follow up in cases of cardiovascular collapse :

  • Patients who have survived from ventricular defibrillator arrest need further assessment and evaluation of cardiac anatomy and left ventricular function is appropriate.
  • Additionally, in absence of a reversible cause , an implantable cardioverter defibrillator can be placed.

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Furthermore, please refer this book for detailed description of the diseases: Harrisons book of internal medicine

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