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<p>List of Contributors xiv</p> <p>Foreword xvii</p> <p>Preface xviii</p> <p><b>Part I Knowledge for Practice </b><b>1</b></p> <p><b>1 Mechanics of the Cardiovascular System </b><b>3<br /></b><i>Brendan Greaney and Angela M. Kucia</i></p> <p>Overview 3</p> <p>Basic Heart Anatomy 3</p> <p>References 11</p> <p><b>2 Regulation of Cardiac and Vascular Function </b><b>12<br /></b><i>Brendan Greaney and Angela M. Kucia</i></p> <p>Overview 12</p> <p>Central Nervous System Regulation of the Cardiovascular System 12</p> <p>Vasomotor Control 14</p> <p>Baroreceptors 14</p> <p>Gravity and Venous Return 14</p> <p>Chemoreceptors 15</p> <p>Humoral Control 16</p> <p>Electrolytes 18</p> <p>Conclusion 19</p> <p>References 20</p> <p><b>3 Cardiac Electrophysiology </b><b>21<br /></b><i>Brendan Greaney and Angela M. Kucia</i></p> <p>Overview 21</p> <p>Cardiac Cells 21</p> <p>The Action Potential 22</p> <p>The Action Potential in Non-Pacemaker Cells 22</p> <p>The Cardiac Conduction System 24</p> <p>The Electrocardiogram 26</p> <p>Conclusion 26</p> <p>References 28</p> <p><b>4 The Coronary Circulation </b><b>29<br /></b><i>Brendan Greaney and Angela M. Kucia</i></p> <p>Overview 29</p> <p>The Coronary Circulation 29</p> <p>The Left Main Coronary Artery 30</p> <p>The Left Anterior Descending Artery 31</p> <p>The Left Circumflex Artery 31</p> <p>The Right Coronary Artery 31</p> <p>Collateral Circulation 32</p> <p>Microvascular Circulation 32</p> <p>Coronary Venous Circulation 32</p> <p>References 33</p> <p><b>Part II Cardiovascular Disease Assessment </b><b>35</b></p> <p><b>5 Risk Factors for Cardiovascular Disease </b><b>37<br /></b><i>Angela M. Kucia and Angela Hartley</i></p> <p>Overview 37</p> <p>Absolute Risk 37</p> <p>Classification of Risk Factors for CVD 38</p> <p>Biomedical Risk Factors 39</p> <p>Behavioural Risk Factors 44</p> <p>Psychosocial Risk Factors 46</p> <p>Conclusion 48</p> <p>References 49</p> <p><b>6 Cardiovascular Assessment </b><b>52<br /></b><i>Jan Keenan and Angela M. Kucia</i></p> <p>Overview 52</p> <p>Health History 53</p> <p>Physical Examination 54</p> <p>Conclusion 65</p> <p>References 66</p> <p><b>7 Laboratory Tests Used in Acute Cardiac Assessment </b><b>67<br /></b><i>David Barrett and Angela M. Kucia</i></p> <p>Overview 67</p> <p>Generic Laboratory Tests 67</p> <p>Common Laboratory Tests Used in Cardiovascular Disease 67</p> <p>Laboratory Specimen Collection 73</p> <p>Conclusion 74</p> <p>References 74</p> <p><b>8 Diagnostic Procedures </b><b>76<br /></b><i>Steven A. Unger and Angela M. Kucia</i></p> <p>Overview 76</p> <p>Purpose of Diagnostic Tests 76</p> <p>Preparation for Diagnostic Procedures 77</p> <p>Medical Imaging Tests 78</p> <p>Electrocardiography Tests 93</p> <p>Physiological Testing 93</p> <p>Stress Testing 95</p> <p>Conclusion 100</p> <p>References 100</p> <p><b>Part III Detection and Management of Heart Rhythm Disturbances </b><b>103</b></p> <p><b>9 Electrocardiogram (ECG) Interpretation </b><b>105<br /></b><i>Carol Oldroyd and Angela M. Kucia</i></p> <p>Overview 105</p> <p>Normal Sequence of Depolarisation and Repolarisation 106</p> <p>Theoretical Basis of Electrocardiography 107</p> <p>ECG Leads 107</p> <p>The Cardiac Axis 110</p> <p>Determination of Heart Rate and Electrocardiographic Intervals 111</p> <p>Chamber Enlargement 112</p> <p>Bundle Branch Block 114</p> <p>ECG Changes Related to Myocardial Ischaemia and Infarction 117</p> <p>Myocardial Infarction 118</p> <p>The ST-Segment 118</p> <p>Pericarditis 118</p> <p>Key Point 119</p> <p>T-Wave Abnormalities 120</p> <p>Q-Waves 120</p> <p>Site of Infarction 121</p> <p>Incremental ECG Leads 121</p> <p>Obtaining a 12-Lead ECG 122</p> <p>Equipment Preparation 122</p> <p>Patient Preparation 123</p> <p>Conclusion 125</p> <p>References 126</p> <p><b>10 Cardiac Monitoring in the Clinical Setting </b><b>128<br /></b><i>Angela M. Kucia and Carol Oldroyd</i></p> <p>Overview 128</p> <p>ECG Monitoring Systems and Lead Formats 129</p> <p>Three-Electrode Monitoring Systems 129</p> <p>Five-Electrode Monitoring Systems 129</p> <p>Twelve-Lead (10 Electrode) Monitoring Systems 130</p> <p>Telemetry Monitoring Systems 131</p> <p>Indications for Arrhythmia Monitoring in the Clinical Setting 132</p> <p>Alarm Fatigue 134</p> <p>References 138</p> <p><b>11 Arrhythmias </b><b>139<br /></b><i>Angela M. Kucia</i></p> <p>Overview 139</p> <p>Mechanisms of Arrhythmia Generation 139</p> <p>Ectopy, Aberrancy and Escape Beats 145</p> <p>Sinus Dysrhythmias 147</p> <p>Atrial Dysrhythmias 150</p> <p>Ventricular Rhythms and Tachyarrhythmias 156</p> <p>Heart Block Related to Atrioventricular Nodal Conduction 162</p> <p>Conclusion 169</p> <p>References 170</p> <p><b>12 Assessment and Management of Cardiac Rhythm Disturbances (Arrhythmias) </b><b>173<br /></b><i>Carolyn E. Shepherd, Jenny Tagney, and Angela M. Kucia</i></p> <p>Overview 173</p> <p>Assessment 173</p> <p>Taking a Clinical History 174</p> <p>Physical Examination 174</p> <p>Diagnostic Investigations 177</p> <p>Smartphone Technology 180</p> <p>Imaging 180</p> <p>Diagnosis of Cardiac Channelopathies 182</p> <p>Treatment Strategies for Arrhythmia 183</p> <p>Pharmacological Therapy 183</p> <p>Electrical (Direct Current) Synchronised Cardioversion 187</p> <p>Defibrillation 188</p> <p>Cardiac Ablation 189</p> <p>Temporary Pacing 190</p> <p>Temporary Transvenous Pacing 190</p> <p>Transcutaneous Pacing 190</p> <p>Other Forms of Temporary Pacing 191</p> <p>Implantable Cardiac Devices 191</p> <p>Implantable Pacemakers 191</p> <p>Implantable Cardioverter Defibrillators 193</p> <p>Implantation Procedure for Cardiac Devices 194</p> <p>Implantable Device Complications 196</p> <p>Practical Advice for Patients Following Device Implantation 197</p> <p>Advanced Nursing Roles in Arrhythmia Management 199</p> <p>References 199</p> <p><b>Part IV Detection and Management of Acute Coronary Syndromes </b><b>205</b></p> <p><b>13 Pathogenesis of Acute Coronary Syndromes </b><b>207<br /></b><i>Angela M. Kucia and John D. Horowitz</i></p> <p>Overview 207</p> <p>Acute Coronary Syndrome 207</p> <p>Atherosclerosis 208</p> <p>Endothelial Dysfunction 208</p> <p>Inflammation 208</p> <p>Plaque Rupture and Thrombosis 209</p> <p>Pathological Characteristics of Myocardial Ischaemia and Infarction 210</p> <p>Conclusion 213</p> <p>References 214</p> <p><b>14 Chest Pain Assessment </b><b>216<br /></b><i>Angela M. Kucia, John F. Beltrame, and Jan Keenan</i></p> <p>Overview 216</p> <p>Background 216</p> <p>Coronary Heart Disease 217</p> <p>Angina Pectoris 217</p> <p>Acute Coronary Syndrome 218</p> <p>Myocardial Infarction with Non-Obstructive Coronaries (MINOCA) 220</p> <p>Presentation with Chest Pain in the Emergency Department 220</p> <p>Typical Clinical Presentation of Ischaemic Chest Pain 221</p> <p>Atypical Presentations 222</p> <p>Chest Pain Assessment 223</p> <p>Physical Examination in ACS Patients 225</p> <p>The 12‑lead Electrocardiogram in ACS 225</p> <p>Troponin 227</p> <p>Clinical Assessment and Risk Stratification in ACS 227</p> <p>Conclusion 228</p> <p>References 228</p> <p><b>15 Risk Stratification in Acute Coronary Syndromes </b><b>231<br /></b><i>Deborah Wright, Cassandra Ryan, and Angela M. Kucia</i></p> <p>Overview 231</p> <p>Background 231</p> <p>The Nature of Risk in Cardiovascular Disease 233</p> <p>Risk Stratification for Differentiating Between Likely Cardiac-Related Pain and Non-Cardiac Pain 233</p> <p>Risk Stratification Tools 235</p> <p>The HEART Score 235</p> <p>Rule-in/Rule-out Strategies for NSTE-ACS 236</p> <p>Conclusion 237</p> <p>References 238</p> <p><b>16 Management of Acute Coronary Syndromes </b><b>240<br /></b><i>Christopher J. Zeitz, Ian D. Jones, and Angela M. Kucia</i></p> <p>Overview 240</p> <p>Background 240</p> <p>Considerations in Nursing Care of the Patient with Acute Coronary Syndrome 241</p> <p>ST Elevation Acute Coronary Syndrome (STE-ACS) 242</p> <p>ST-segment Myocardial Infarction (STEMI) 242</p> <p>Ischaemic ECG Abnormalities not Meeting STEMI Criteria 245</p> <p>Cardiac Biomarkers in STEMI 245</p> <p>Principles of Reperfusion Strategies 245</p> <p>Mechanical Reperfusion 246</p> <p>Role of the Nurse when Caring for a Patient Receiving Thrombolysis 248</p> <p>Complications of STEMI 249</p> <p>Non-ST-segment Elevation Acute Coronary Syndrome (NSTE-ACS) 252</p> <p>Convalescence and Secondary Prevention 253</p> <p>Conclusion 254</p> <p>References 255</p> <p><b>17 Discharge Planning and Convalescence </b><b>257<br /></b><i>David R. Thompson, Patricia M. Davidson, and Rosemary A. Webster</i></p> <p>Overview 257</p> <p>Hospitalisation 257</p> <p>Patient and Partner Reactions and Needs after an Acute Cardiac Event 258</p> <p>Discharge Planning 258</p> <p>High-Risk Groups 260</p> <p>Convalescence 261</p> <p>Promoting Self-Care and Self-Management in the Convalescent Phase 263</p> <p>Common Concerns of Partners and Family Members 265</p> <p>Facilitating Convalescence 265</p> <p>Home-Based Services 266</p> <p>Nurse-Led Clinics 266</p> <p>Community Health Workers 266</p> <p>Information Technology 267</p> <p>Nursing Strategies to Promote Convalescence 267</p> <p>Palliative Care 267</p> <p>Conclusion 267</p> <p>References 268</p> <p><b>18 Prevention Strategies in Cardiovascular Disease </b><b>272<br /></b><i>Rosemary A. Webster, Patricia M. Davidson, Praba Rabasse, and Angela M. Kucia</i></p> <p>Overview 272</p> <p>Prevention Strategies 272</p> <p>Primary Prevention in Cardiovascular Disease 273</p> <p>Secondary Prevention in Cardiovascular Disease 273</p> <p>Target Population for Secondary Prevention 274</p> <p>Cardiac Rehabilitation 274</p> <p>Assessment and Short-Term Monitoring 276</p> <p>Lifestyle/Behavioural Modification 276</p> <p>Psychosocial Risk Factors 283</p> <p>Medication Adherence 283</p> <p>Recovery and Longer-Term Maintenance 284</p> <p>Conclusion 285</p> <p>References 285</p> <p><b>Part V Cardiac Arrest </b><b>289</b></p> <p><b>19 Sudden Cardiac Death </b><b>291<br /></b><i>Pete Gregory and Angela M. Kucia</i></p> <p>Overview 291</p> <p>Background 292</p> <p>Burden of Disease 292</p> <p>Risk Factors for Sudden Cardiac Death 293</p> <p>Screening in the General Population for Risk of Sudden Cardiac Death 294</p> <p>Mechanisms of Sudden Cardiac Death 294</p> <p>Sudden Cardiac Death in Structural Heart Disease 296</p> <p>Cardiomyopathies and Sudden Cardiac Death 297</p> <p>Inherited Primary Arrhythmia Syndromes 298</p> <p>Sudden Cardiac Death Related to Special Populations 300</p> <p>Impact of Sudden Cardiac Death on Families and Loved Ones 300</p> <p>Conclusion 303</p> <p>References 303</p> <p><b>20 Pre-hospital Management of Cardiac Emergencies </b><b>306<br /></b><i>Pete Gregory and Angela M. Kucia</i></p> <p>Overview 306</p> <p>Introduction 307</p> <p>Hazards to the Victim and Rescuer 308</p> <p>Scene Safety 308</p> <p>Risks to the Rescuer 308</p> <p>Resuscitation During the COVID-19 Pandemic 308</p> <p>Risks to the Victim 309</p> <p>Circumstances that make OHCA Different from Hospital Resuscitation 310</p> <p>Pauses in Chest Compressions 312</p> <p>Automated External Defibrillation 312</p> <p>Practical Factors Affecting Defibrillation 312</p> <p>Chest Compressions Following Defibrillation 313</p> <p>Conclusion 313</p> <p>References 314</p> <p><b>21 In-Hospital Resuscitation </b><b>317<br /></b><i>Angela M. Kucia and Melanie Rushton</i></p> <p>Overview 317</p> <p>Prevention: Systems for Identifying Patients at Risk of Cardiac Arrest 319</p> <p>Recommended Strategies for the Prevention of Avoidable Cardiac Arrest 320</p> <p>Rescuer Safety 323</p> <p>Equipment 325</p> <p>Basic Life Support 325</p> <p>Advanced Life Support 326</p> <p>Post-Resuscitation Care 327</p> <p>Audit and Data Collection 328</p> <p>Conclusion 328</p> <p>References 329</p> <p><b>22 Ethical Issues in Resuscitation and end of Life Care </b><b>332<br /></b><i>Angela M. Kucia and Annabella S. Gloster</i></p> <p>Overview 332</p> <p>Guiding Ethical Principles in Resuscitation 332</p> <p>Medical Futility 333</p> <p>Resuscitation Orders 334</p> <p>Advanced Care Planning and Advanced Directives 335</p> <p>Withdrawal of Treatment 336</p> <p>Witnessed Resuscitation 337</p> <p>Organ Donation 337</p> <p>Training and Research with the Newly Dead 338</p> <p>Conclusion 338</p> <p>References 339</p> <p><b>Part VI Chronic Cardiac Conditions </b><b>341</b></p> <p><b>23 Heart Failure </b><b>343<br /></b><i>Salimah Hassan, Christopher Nicholson, Robyn Lotto, and Angela M. Kucia</i></p> <p>Overview 343</p> <p>Definition of Heart Failure 344</p> <p>Heart Failure Terminology 344</p> <p>Epidemiology 346</p> <p>Significance 347</p> <p>Prognosis 347</p> <p>Aetiology 347</p> <p>Diagnosis 348</p> <p>Investigations 353</p> <p>Chronic Heart Failure Management 354</p> <p>Comorbidities in Heart Failure 361</p> <p>Systems of Care 364</p> <p>End of Life 365</p> <p>Acute Heart Failure 365</p> <p>Conclusion 367</p> <p>References 367</p> <p><b>24 Congenital Heart Disease </b><b>372<br /></b><i>Robyn Lotto, Christopher Nicholson, and Angela M. Kucia</i></p> <p>Overview 372</p> <p>Background 372</p> <p>Epidemiology 372</p> <p>Risk Factors for the Development of Congenital Heart Disease 373</p> <p>Embryology 374</p> <p>Congenital Heart Disease Classification 375</p> <p>CHD with Shunt Between Systemic and Pulmonary Circulation 376</p> <p>Acyanotic CHD 378</p> <p>Acyanotic CHD with Outflow Obstruction 381</p> <p>Cyanotic CHD 383</p> <p>Dextrocardia 386</p> <p>Conclusion 393</p> <p>References 394</p> <p><b>25 Structural Heart Disease </b><b>399<br /></b><i>Christopher Nicholson, Salimah Hassan, Robyn Lotto, and Angela M. Kucia</i></p> <p>Overview 399</p> <p>Valvular Heart Disease 399</p> <p>Cardiomyopathy 404</p> <p>Other Forms of Cardiomyopathy 407</p> <p>The Multidisciplinary Team Caring for Patients with Acquired Structural Heart Disease 408</p> <p>Conclusion 408</p> <p>References 409</p> <p><b>26 Takotsubo Syndrome </b><b>412<br /></b><i>Angela M. Kucia</i></p> <p>Overview 412</p> <p>Background 412</p> <p>Epidemiology 413</p> <p>Prognosis 413</p> <p>Pathophysiology 415</p> <p>Triggers for TTS 416</p> <p>Clinical Presentation 417</p> <p>Wall Motion Abnormalities in TTS 419</p> <p>Cardiac Biomarkers 420</p> <p>Diagnostic Criteria 420</p> <p>Diagnostic Imaging 420</p> <p>Clinical Course 421</p> <p>Management 422</p> <p>Conclusion 423</p> <p>References 424</p> <p><b>27 Non-Obstructive Coronary Artery Disease (<i>MINOCA/INOCA</i>) </b><b>428<br /></b><i>Angela M. Kucia and John F. Beltrame</i></p> <p>Overview 428</p> <p>Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) 428</p> <p>Management 430</p> <p>Conclusion 434</p> <p>References 435</p> <p>Index 437</p>

<p><b>Angela M. Kucia,</b> Department of Cardiology, The Lyell McEwin Hospital and UNISA Clinical and Health Sciences, University of South Australia, Australia.</p> <p><b>Ian D. Jones,</b> School of Nursing and Allied Health, Liverpool John Moores University, United Kingdom.

<p><b>SECOND EDITION</p> <p>CARDIAC CARE <p>A PRACTICAL GUIDE FOR NURSES</b> <p>In the newly revised Second Edition of <i>Cardiac Care: A Practical Guide for Nurses</i>, a team of dedicated and widely recognised nursing medical experts from around the world deliver an invaluable and practical guide for nurses who practice in cardiac care environments. <p>This latest edition includes brand new chapters on structural heart disease, takotsubo syndrome, and non-obstructive coronary artery disease. While also covering the essential topics necessary for the proper provision of cardiac care, this practical guide for nurses provides: <ul><li>A thorough introduction to cardiac practice, including the mechanics of the cardiovascular systems and the regulation of cardiac and vascular function</li> <li>Comprehensive exploration of cardiovascular disease assessment, including risk factors for cardiovascular disease, laboratory tests, and diagnostic procedures</li> <li>Practical discussions of the detection and management of heart rhythm disturbances, including ECG interpretation, cardiac monitoring, and arrhythmias</li> <li>In-depth examinations of the detection and management of acute coronary syndromes, including chest pain assessment and discharge planning</li> <li>Chapter overviews, key concepts, learning objectives and activities, with critical points intermingled throughout</li></ul> <p>Perfect for practicing nurses who care for patients with cardiac conditions, <i>Cardiac Care: A Practical Guide for Nurses</i> will also earn a place in the libraries of other allied health professionals in cardiac care settings.

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