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1. Analyze EKG, physiologic, vascular, and structural changes related to myocardial ischemia.
2. Breakdown acute mitral regurgitation due to papillary muscle dysfunction, ventral septal defects, and the acute physiologic symptoms observed.
3. Communicate acute cardiac interventions including pharmacological, percutaneous and surgical treatments.
4. Point out the etiology and symptoms of cardiogenic shock and treatments utilized.
5. Analyze Stanford type A and B aortic dissection and treatments for each including which type requires emergency cardiac surgery.
6. Breakdown symptoms of cardiac tamponade and appropriate treatments.
7. Evaluate acute cardiac rhythm changes, etiology, and treatments for each including pharmacological and invasive interventions.

Acute Cardiac Pathology

• Differentiate between an ST elevation MI and a non ST elevation MI
• What about the presentation based on different coronary vessel involvement?
• Review angiogram films to identify specific pathology including culprit vs. chronic lesions
• When are thrombolytics appropriate?
• When should an invasive procedure like angioplasty or stenting be performed?
• When to refer to surgery – including timing of urgent and elective surgery
• See the changes of acute MV regurgitation caused by myocardial ischemia on echocardiogram
• MR treatments: Pharmacology? When is it time for surgery or catheter-based interventions?
• Find out how an intra-aortic balloon pump can stabilize a patient with ventral septal defect caused by MI prior to surgery
• Review which drugs are most beneficial for specific conditions and adhere to AHA recommendations

Cardiogenic Shock

• Understand the multiple causes of cardiogenic shock to identify early symptoms
• Compare the function of diagnostic techniques, including echocardiogram and swanganz catheters
• Gain insight into typical and more advanced treatments including fluid resuscitation, medication, interventions, intra-aortic balloon pumps, ECMO, and VADs

Aortic Dissection

• Stanford types A and B – including common causes, which patients are at risk, and typical presenting symptoms
• Review diagnostic techniques and images including echocardiogram, TEE, and CT scans for pathological findings
• Which patients require emergency surgery vs. medical management?
• Explore the latest surgical techniques used in treatment

Cardiac Tamponade

• Identify the symptoms of cardiac tamponade including the components of Beck’s triad
• Learn the causes of pericardial tamponade
• Review diagnostic echocardiogram and CT images
• Appropriate treatments including pericardiocentesis and pericardial window surgical procedures

Arrhythmias

• Identify acute cardiac arrhythmias including atrial fibrillation/flutter, 3rd-degree heart block and ventricular tachycardia by EKG findings
• Review common etiologies and risk factors
• Explore treatment options including medication, electricity, and ablation procedures

Tom Gutchewsky is certified as an Acute Care Nurse Practitioner and currently practices as an Advanced Practice Nurse in Cardiac Surgery working outside of Chicago with a cardiac surgery group that performs over 2000 procedures annually, including left ventricular assist devices and heart transplantation. He has over 20 years of bedside experience having worked in the Cardiac ICU, the Surgical ICU, and as the APN for Cardiac Surgery. Tom has been a nurse practitioner for over 18 years, primarily with open heart surgery, also assisting in the operating room and has worked with Cardiology, EP, and interventional radiology. He precepts nurse practitioner students in the open heart ICU and has previously taught undergraduate nursing students.

Speaker Disclosures:

Financial: Thomas Gutchewsky has an employment relationship with Palos Hospital. He receives a speaking honorarium from PESI, Inc.

Non-financial: Thomas Gutchewsky has no relevant non-financial relationships to disclose.

Save time and $10 off the price of other submission methods – purchase & take the CE test online for $9.99 USD per participant. Additional processing fees apply for other submission methods (i.e. mail, fax, etc.). Please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion are available for email, download and/or printing from your online account immediately following the successful completion of the post-test/evaluation.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 5/11/2020
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 7.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Other Professions
This self-study activity qualifies for 6.0 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Nurses and other Healthcare Professionals