CAD Flashcards

1
Q

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?

A

Papillary wall rupture.

RV infarct would not have clear lung bases.

Ventricular septal rupture more common in anterior wall MI

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2
Q

What is the first line drug in patient with STEMI and AFib RVR?

A

Beta blockers

CCB May be given if contraindication to BB such as wheezing.

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3
Q

In a patient with ACS and established history of HIT, what is the preferred anti-coagulant?

A

Bivalirudin

Fondaparinux may also be used but has been associated with higher rates of catheter thrombus at time of PCI

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4
Q

First line therapy in isolated hypertriglyceridemia?

A

Fenofibrate or Niacin

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5
Q

What is the correct order of events in the ischemic cascade?

A

Perfusion defects —> diastolic dysfunction —> systolic dysfunction —> EKG changes —> Chest pain

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6
Q

Pressure waves:

A

Constriction: rapid X and Y descent

Tamponade: rapid X descent

Restriction: rapid Y descent

TR: No X or Y descent. Prominent V wave

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7
Q

Diastology Echo values:

A
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
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8
Q

What are significant values for iFR and FFR?

A

IFR: < or = 0.89

FFR: < or = 0.80

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