Angina Flashcards
Investigations of stable angina
Stress echo
Stress ECG
FBC for anaemia
White blood cells - infections (pericarditis)
U&E (kidney function for drugs that will be prescribed)
BNP
What do you look for on a stress echo?
Valvular incompetence
Apical akinesia
What do you prescribe?
GTN spray immediately
Potentially aspirin and clopidogrel
What is BNP suggestive of?
Heart failure (as atria are stretched and release BNP)
How does a GTN spray work?
Nitrous oxide - vasodilation
there aren’t any NO receptors
What is the best position to sit in during angina?
W position - lie against wall and pull knees in so that the body is mainly below the heart
What does an ST elevation actually mean in terms of the heart?
The ischemia is transmural (totally across a wall)
Later Q waves develop
Normal trops and NSTEMI??
Unstable angina
When you’re looking at ST elevation, what do you need to look for to properly confirm it?
the isolectric line - has to be higher than this
What does a posterior MI look like on an ECG?
ST DEPRESSION on anterolateral leads
If you flip the ECG over, it would show ST elevation
Complications of MI
Life threatening VT/VF
Cardiogenic shock (if the ischemia is transmural)
Bradyarrhythmia (esp with inferior MI)
Ventrical septal rupture/wall rupture as a result of it becoming necrotic
Mitral regurgitation due to papillary muscle ischemia
HF
Chronic
AF
What is a complication of inferior MI
Bradyarrythmia
