Cardiovascular Pipe Problems You Should Know for the EMT Exam

By Arthur Hsieh

Study up on cardiovascular pipe problems for the EMT exam. The body’s vasculature can develop leaks that cause fluid to leave the system quickly. On occasion, part of the vasculature can weaken, potentially causing massive failure. Check out these common vasculature conditions.

Problem Signs and Symptoms Action Steps
Aortic aneurysm/dissection A weakening in the aorta’s wall causing it to bulge out
(aneurysm) or tear (dissection) resulting in loss of pressure and
bleeding. Patient may complain of sudden tearing or knifelike pain
in chest or centered between shoulder blades; may have unequal
pulses in arms or legs; may experience a rapid drop in blood
pressure, tachycardia, or tachypnea. In rare cases, may have a
palpable abdominal mass.
Move patient quickly but carefully; lay supine if possible.
Administer oxygen to maintain saturation. Maintain body
Hypertensive emergency Sudden rise in blood pressure over minutes to a few hours.
Patient may have a rapid onset of headache; a spontaneous
nosebleed; sudden ringing in the ears (tinnitus); a strong,
bounding pulse; or very high blood pressure.
Place patient in position of comfort; try to keep head
elevated. Maintain oxygen saturation levels with supplemental
oxygen. Attempt to control any nosebleed by pinching near base of
nose and having patient lean forward.
Severe infection (sepsis) Toxins from bacteria cause vasculature to leak fluids to
surrounding tissue (third spacing). Patient may have signs of
infection (fever, nausea, vomiting, diarrhea); decreasing oral
fluid intake; hypotension, tachycardia, or tachypnea. Skin may be
hot, dry, and pale with dark purple-colored areas where
microbleeding is occurring (purpura), especially in dependent body
areas of the back, buttocks, and legs.
Place patient in supine position and monitor closely for signs
of difficulty breathing. If patient is in shock, administer
supplemental oxygen to maintain saturation and prevent body
temperature loss.
Anaphylaxis Massive immune response causes vasculature to dilate and leak
fluid. Patient may identify source of allergen (a bee sting or
peanuts, for example); may aucultate stridor or wheezing; may have
hives or swelling of upper airway, hypotension, tachycardia, or
Remove allergen if possible; assist patient with prescribed
epinephrine autoinjector; if patient is in shock, administer
supplemental oxygen to maintain saturation and prevent body
temperature loss.

A 53-year-old male is lifting several boxes at work when he feels sudden, knife-like pain in the middle of his back. He is awake and anxious, with cool, pale, and diaphoretic skin. He has a history of back surgery and hypertension. His radial pulse is weak, fast, and thready; you cannot detect pedal pulses. Of the following suspected conditions, which is most likely?

  • (A)Aortic abdominal aneurysm

  • (B)Ruptured vertebral disk

  • (C)Unsuspected angina

  • (D)Diaphragmatic hernia

The correct answer is Choice (A). The faint, fast, radial pulse and loss of pedal pulses point to a loss of blood pressure, which isn’t likely to result from a vertebral disk rupture, angina, or a diaphragmatic hernia, Choices (B), (C), and (D), respectively.