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JazCardio > Angina and Acute Coronary Syndromes > Flashcards

Angina and Acute Coronary Syndromes Flashcards

1
Q

In Angina you experience a ___ pain due to ____

A

visceral ; myocardial hypoxia

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2
Q

Differentials for anginal pain:

A

oesophageal spasm, biliary colic, peptic ulcer, GORD, MSK, pericarditis, pleuritic pain

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3
Q

angor animi =

A

fear of dying

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4
Q

Reperfusion causes _____ and a ______ (which can cause ______)
both are a cause of death post-MI

A

arrhythmias

lengthened QT region -> polymorphic VT may lead to re-entrant tachycardias

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5
Q

Post-MI can get cardiogenic shock if:

A

delayed presentation
multivessel disease
complications eg. mitral regurg, VSD, rupture

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6
Q

Gold-standard test for ischaemic CVD

A

angiography - done before get angioplasty

anatomical and risk stratification

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7
Q

Angiography involves inserting a catheter into the ___/___ into the _____ inject contrast and then ____

A

wrist/groin
coronary ostium
x-ray

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8
Q

Non-invasive but less precise form of imaging the coronary arteries than angiography if calcium is present

A

CT angiography

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9
Q

Anterior MI shows up as STE in _____ ECG leads

Reciprocal ST depression in ___

A

V1-6

III and avF

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10
Q

Anteroseptal MI shows as STE in ____ ECG leads

A

V1-4

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11
Q

Septal ECG leads =

A

V1-2

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12
Q

Anterolateral MI shows STE in ____ ECG leads

A

avL, I, V3-6

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13
Q

Inferior MI shows STE in ____ ECG leads

A

II III avF

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14
Q

Lateral ECG leads =

A

I, avL, avR, V5, V6

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15
Q

Inferior ECG leads =

A

II, III, avF

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16
Q

Anterior leads =

A

V3-4

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17
Q

Stable angina =

A

fixed stenosis
demand-led ischaemia
stop sit and GTN spray

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18
Q

ACS = (3)

A

unstable angina
NSTEMI
STEMI

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19
Q

ACS is ____ led ischaemia due to ___

A

supply-led

obstruction - subtototal/complete - dynamic stenosis

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20
Q

old/new plaques are more likely to rupture due to ____ cap

A

new

thin fibrous cap

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21
Q

Signs of MI that can be seen in an ECG

A

STE, T inversion, pathological Q waves

22
Q

Diagnosis of a STEMI needs

A

> =1mm STE in 2 adjacent limb leads
OR
=2mm STE in >=2 contiguous precordial leads

23
Q

Cardiac enzyme that peaks 24hr after MI

also in muscle and brain

A

CK - creatinine kinase

24
Q

Treatment of STEMI

A 
MONAC
IV Morphine
O2 if hypoxic
Nitrate (GTN IV) if >90mmHg
Aspirin and clopidogrel 300mg
\+anti-emetic
25
Q

no acute complete occlusion of coronary vessel because plasmin performs intravascular thrombolysis =

A

NSTEMI

26
Q

ST depression indicates

A

ischaemia

27
Q

For NSTEMI treatment =

A

immediately - heparin
long term - aspirin and clopidogrel for 3 months
possibly tirofiban
asap (outpatient) coronary angiogram and revascularisation

28
Q

Aim to defibrillate cardiac arrest within ___

A

3 minutes

29
Q

How to measure rate of irregular HR on ECG

A

no. QRS in 30 boxes x 10

30
Q

ECG leads that are normally inverted

A

avR, V1,2,3

31
Q

If ____ = left axis deflection

A

avF inverted

32
Q

If _____ = right axis deflection

A

I inverted

33
Q

If _____ = extreme right axis deflection

A

I and avF inverted

34
Q

To increase pre-load in cardiac arrest

A

IV fluid

raise legs

35
Q

No pulse, unresponsive and non-breathing

A

cardiac arrest

36
Q

Pulse, unresponsive and non-breathing

A

pulmonary arrest

37
Q

In cardiac arrest assess O2 delivery factors by :

A

ABG/pulse oximetry - SaO2
Full blood count - Hb
ECG/pulse - HR

38
Q

CPR = ___compressions ___ deep at a rate of ___
then ___ rescue breaths lasting ___
Position =

A

30 compressions 5-6cm 100-120/min
2 breaths ; less than 10s
middle of the chest

39
Q

Shockable heart rhythms

A

pulseless VT

VF

40
Q

Non-shockable heart rhythms

A

PEA

asystole

41
Q

ALS =

(___ -> __CPR ) repeat then on ___ shock give ___ and then after every alternative shock

A

Shock -> 2min
3rd
adrenaline

42
Q

for PEA / asystole (may have p but no QRS) give __ adrenaline every ___mins/___cycles

A

1mg
3-5mins
2 cycles

43
Q

4Ts and 4Hs of reversible causes of cardiac arrest

A

hypoxia - hypovolaemia
hypo/hyperkalaemia - hypothermia
thrombosis - tension pneumothorax
tamponade - toxins

44
Q

Bag ventilation / laryngeal mask airway (LMA) / supraglottic airway device (SAD) for

A

hypoxia in cardiac arrest

45
Q

After cardiac arrest transfer to ___

A

critical care area

46
Q

Cardiomalacia perforens =

A

mushy wall post MI and can burst => tamponade / septal defect

47
Q

To diagnose pathological pulmonary oedema must get patient to ___ and then listen to chest again

A

cough - post-pertussive inspiratory crackles

elderly get secretory crackles that go away when cough / move

48
Q

A(n) ____ infarction is caused by a blockage in the LAD

This shows as STE in leads ____

A

anteroseptal

V1-V4

49
Q

A(n) ____ infarction is caused by a RCA blockage

This shows as STE in leads ___

A

inferior

II III avF

50
Q

A(n) ___ infarction is caused by circumflex occlusion

Shows as____ on ECG

A

posterior

tall R and ST depression in V1-2

51
Q

PE most commonly causes ___ on ECG

Rarely causes characteristic _____

A

sinus tachy
SIQIIITIII pattern - deep S waves in I
pathological Q in III
inverted T waves in III

JazCardio (15 decks)

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