7: ACS, Angina Flashcards

1
Q

modifiable RFs for CAD

A
  1. HTN
  2. HLD
  3. DM
  4. obesity
  5. cigarettes
  6. physical inactivity / unhealthy diet
  7. stress
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2
Q

non-modifiable RFs for CAD

A
  1. male
  2. older than 45
  3. FHx premature CAD
  4. African american, hispanic, southeast asian
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3
Q

four non-traditional RFs for CAD

A
  1. CKD
  2. proteinuria
  3. metabolic syndrome
  4. inflammatory states
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4
Q

what % of MI’s are painless or atypical symptoms

A

20%

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5
Q

populations more likely to have atypical or silent MI

A

women, elderly, diabetics

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6
Q

how do vasodilators vs inotropes/cronotropes work in a cardiac stress test?

A

vasodilators: coronary A’s are already max dilated at rest, so they receive less flow when whole body is dilated
inotropes: increases myocardial O2 demand

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7
Q

explain stress MPI

A
  1. administer IV radioisotope

2. use a special camera system to detect gamma photons

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8
Q

what to observe for during a dobutamine stress ECHO

A

regional wall abnormalities: hypokinesis, akinesis, or dyskinesis

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9
Q

what % is considered significant stenosis?

A

70%

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10
Q

if a patient has a past/known ___ on ECG, you cannot diagnose a STEMI

A

LBBB

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11
Q

there are multiple types of acute MI, but what are Type I and II?

A

Type I: infarct due to coronary atherothrombosis

Type II: infarct due to supply-demand mismatch

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12
Q

three CABG indications

A
  1. 3 vessel disease >70% stenosis
  2. left main disease
  3. LV dysfunction
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13
Q

three drugs that improve mortality in MI

A
  1. ASA
  2. B Bs
  3. ACEi’s
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14
Q

when to use thrombolytics like tPA?

A

STEMI only

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15
Q

MOA for aspirin, P2Y12 inhibitors, and GPIIb/IIIA inhibitors

A
  1. ASA: blocks COX1 and 2
  2. P2Y12 inhibs: blocks platelet recruitment/activation
  3. GPIIb/IIIA inhibs: block platelet aggregation
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16
Q

how does tPA work?

A

activates plasminogen -> plasmin -> breaks up clots

17
Q

STEMI diagnosed at a PCI capable vs incapable hospital

A
  1. PCI capable: administer drugs -> PCI in <90mins

2. not PCI capable: thrombolytics in <30mins -> transfer to PCI hospital in <120mins

18
Q

what does a TIMI score predict?

A

risk of 14 day death, recurrent MI, or urgent revascularization

19
Q

what artery is blocked in MI’s: inferior, septal, anterior, posterior, lateral

A
  1. inferior: RCA
  2. septal: LAD
  3. anterior: LAD
  4. Lateral: LCx
  5. posterior: PDA
20
Q

what leads show MI in: inferior, septal, anterior, posterior, lateral

A
  1. inferior: 2, 3, aVF
  2. septal: V1-V2
  3. anterior: V2-V4
  4. posterior: V1-V3
  5. lateral: V5-V6 OR I, aVL
21
Q

why is ECG a little different for a posterior MI?

A

tall R waves and ST depression bc theres no leads directly for the posterior heart

22
Q

DDx of acute MI

A
  1. aortic dissection
  2. PE
  3. pericarditis, pleuritis
  4. PNA, pneumothorax
  5. GERD, PUD, esophageal spasms/rupture
  6. costochondritis