ACE Review - Cards Flashcards
In pt with suspected Stemi, what is initial treatment
Cath lab, percutaneous intervention…angioplasty vs stent
Mitral stenosis physiologic needs
Slow heart rate. Preload.
Is the PAP in mitral stenosis falsely estimating the left ventricle end diastolic pressure to high or too low
Falsely estimates it too hi. Real value is lower
Mitral stenosis vasopressor.
Phenylephrine
how long does ck and ckmb last in a MI patient
2 days
how long does troponin last in a MI patient
10 days
what is pulsus paradoxus
an exaggerated decrease in sbp on inspiration
what cardiac conditions cause pulsus paradox
tamponade, constrictive pericarditis, heart failure
what lung problems can cause pulsus paradox
emphysema, asthma, pneumothorax
what misc caues for pulsus paradox
obesity, PE
does pna cause pulsus
no
what is associated with arterial line occlusion
prolong line, non teflon, size of radial arter, ratio of cath to radial artery, increased attempts, hematoma formation
when is an radial artery considered a thromboocclusion
it is considered time after the cath has been removed and a thrombus forms
what is the time frame for thromboocclusion of radial artery s/p cath
occurs within 48 hours after decannulation
does transfixtion aka through and through methoid increase arterial aa occlusion
no
when has heparinization of cathethers been proven useful to prevent thromboocclusion of radial aa
it is beneficial in arterial lines kept in longer than 24 hours
following cardiothoracic surgery, how many patients develop afib
30 to 60%
what are electrolyte causes for afib in ct surg patients
hypokalemia and hypomag
besided elelctrolyte abnorm, what other risk factors for afib s/p ct surg
male, age above 60, preop tachycardia, reduced post op card output, post op increase in b naturetic peptide
What is the ACC and AHA recommened about pt who just got drug-eluting stents
wait for 1 year after placement for elective surgeries
how much risk reduction do we see with delaying elective surgerys s/p placement of drug eluting stents
50% reduction…from 6.4 to 3.3% of cardiac injury
what is the risk of having surgery after having a stent placed
the antithrombotic will be stopped and pt is at increased risk of thrombosing the stent
what is the moa of rethrombosing the stent
lack of time for re-endothilization, procoagulant state induced by stress of surgery, rebound of procoagulant state after stopping dual antithrombotic drugs
what drugs are used in dual antiplatelet therapy for stented patients
aspirin and clopidogrel