Acute coronary artery disease Flashcards
assessment for time for PCI
90 MIN
assessment time for fibrinolysis
12hours (3 hours is preferred)
Killip Class class 1`
no symptoms
class 2
rales crakles s3 jvd
class3
frank pulmonary edema
class4
cardio shock
patient with MI comes in, assessment you see Hypotension, hypovolemia, and respiratory depression should morphine be given
no
patient taking sildenafil comes in with MI what should you not give for treatment
nitroglycerin
patient discharge after MI history of DM what is one medication we should not give
betablocker
Patient not tolerating ACE what could be replaced
ARB
Patient not tolerating ACE what could be replaced
ARB
Patient had anterior MI, history of pulmonary congestion, and LVEF less than 40 what medication should be given
ACE
patient just had NSTEMI would like to go home on antiplatelet agent
say no
Patient comes in with chest pain history of depressed systolic left ventricle function, right now ST depression is seen and elevated cardiac markers are noted what risk is this patient for ACS
High risk
Patient comes in chest pain, what is seen is Twave inversion, and slight elevated cardiac markers, after 10 minutes pain is gone what risk
intermedicate
What are the items of invasive therapy
coronary angiography and revascularization within 12 to 48 hours
MONA+BAH
clopidigrel
secondary prevention disease management for Blood pressure considerations
Goals less than 140/90 (less 130/80 if DM / CKD)
Maximized Betablockers and ACEI
secondary prevention disease management for lipids considerations
LDL< 100 TG<200
Maximize use of Statins, consider fibrates/niacin, omega3 for TG
What is in the medication checklist for a patient after MI
Antiplatelet agent -aspirin Lipid lower agent -Statin Antihypertension agent -Beta bloker - ACEI - Aldactone
Patient given nitrates and beta blockers, comes back next day and says it’s not working. What can you give
Calcium channel blockers
Patient with recent acute coronary artery has ldl of greater than 100. What medication should be given for cholesterol and within what time?
Statin therapy
With in 24 to 96 hours
Patient admitted with aute coronary syndrome HDR less than 40 what medicine is beneficial for hdl
Fibrates or niacin
Patient after ACS asks to f there are any supplements that could be taken to reduce death after MI
Fatty fish and fish oil supplements
Patients ask after ACS what herbal supplements can be taken to relieve angina, you suggest
L-arginine, L-caritine and B complex vitamins
