CAD Flashcards
Patient is 2 days post inferior wall MI and is in cardiogenic shock with crackles in lung bases and no murmur on exam. Most likely diagnosis?
Papillary wall rupture.
RV infarct would not have clear lung bases.
Ventricular septal rupture more common in anterior wall MI
What is the first line drug in patient with STEMI and AFib RVR?
Beta blockers
CCB May be given if contraindication to BB such as wheezing.
In a patient with ACS and established history of HIT, what is the preferred anti-coagulant?
Bivalirudin
Fondaparinux may also be used but has been associated with higher rates of catheter thrombus at time of PCI
First line therapy in isolated hypertriglyceridemia?
Fenofibrate or Niacin
What is the correct order of events in the ischemic cascade?
Perfusion defects —> diastolic dysfunction —> systolic dysfunction —> EKG changes —> Chest pain
Pressure waves:
Constriction: rapid X and Y descent
Tamponade: rapid X descent
Restriction: rapid Y descent
TR: No X or Y descent. Prominent V wave
Diastology Echo values:
Abnormal values: E’ lateral < 10 E’ septal < 7 E/e’ > 14 LA volume > 34 TR vmax > 2.8m/s MV E/A ratio <0.8 or > 2.0
What are significant values for iFR and FFR?
IFR: < or = 0.89
FFR: < or = 0.80