8 - Cardio Emergency

Question 1

This occurs with effusion or hemorrhage into the pericardium

Answer 1

cardiac tamponade

Question 2

s/s of cardiac tamponade

Answer 2

sob, chest discomfort, edema, fatigue, tachy, JVP, PULSUS PARADOXUS, pericardial rub

Question 3

What will cardiac tamponade look like on echo?

Answer 3

chamber collapse

Question 4

What will cardiac tamponade look like on CXR?

Answer 4

large cardiac silhouette

Question 5

Tx of cardiac tamp?

Answer 5

1) pericardiocentesis

2) open sx drainage

Question 6

What does EKG look like with cardiac tamp?

Answer 6

1) tachy
2) ELECTRICAL ALTERNANS
3) low voltage

Question 7

This is predictable and relieved by rest or ntg

Answer 7

stable angina

Question 8

Does unstable angina respond to rest or nitro?

Answer 8

maybe, just know it is ANY change to stable

Question 9

Vasospasm causing chest pain

Answer 9

variant angina

Question 10

What is the ischemic heart dz trifecta?

Answer 10

1) stable
2) unstable
3) MI

Question 11

What does acute coronary syndrome include

Answer 11

1) unstable
2) NSTEMI
3) STEMI

Question 12

Which acute coronary syndrome has ST depression or T wave inversion?

Answer 12

NSTEMI

Question 13

Which acute coronary syndrome occurs with new LBBB

Answer 13

STEMI

Question 14

Which acute coronary syndrome is the only one to have negative cardiac biomarkers?

Answer 14

unstable

Question 15

Which acute coronary syndrome has non specific T wave changes?

Answer 15

unstable

Question 16

As Oprah says, what are the universal treatments for any acute coronary syndrome?

Answer 16

1) ASA (chew 81mg x 2)
2) anticoag (LMWH, Hep) for cath pt’s
3) NTG and morphine (vasodilators)
4) BB’s

Question 17

Thienopyridine inhibitors are what?

Answer 17

Plavix, give that to all acute coronary patients as well.

Question 18

When would you cath a patient with likely unstable angina (normal EKG and no cardiac markers)

Answer 18

Any signs of instability like arrhythmia.

Question 19

Chest pain in ED. What do you do???

Answer 19

1) EKG
2) order cardiac markers
3) Meds
4) TIMI score
5) prepare for cath lab if appropriate.

Question 20

Do you have to cath NSTEMI patients?

Answer 20

No, admit and monitor. Cath only if becomes unstable or symptoms are not resolving/worsening.