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COMAT - IM > CAD/ACS > Flashcards

CAD/ACS Flashcards

(50 cards)

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1
Q

What are the indications for a CABG?

A
  • LAD is affected
  • 3 vessel disease
  • 2 vessel disease if a diabetic
  • Symptomatic despite maximal therapy
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2
Q

What is the physiology behind angina?

A

Oxygen supply cannot meet the demand of the heart!

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3
Q

Describe how stable angina will present?

A

Exertion/stress
–> Chest pain
–> Relieved by rest or nitrates

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4
Q

Describe how stable angina will present?

A

Exertion/stress
–> Chest pain
–> Relieved by rest or nitrates

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5
Q

Can you have other symptoms such as diaphoresis, SOB, dizziness, N/V with stable angina?

A

YES

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6
Q

What will the results of the EKG and Cardiac Enzymes be with Stable Angina? Unstable Angina?

A

NEGATIVE

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7
Q

What defines Unstable Angina?

A
  • Chest pain now occurring at rest
  • Chest pain that is worsening in nature, such that is occurs easier, lasts longer, etc.
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8
Q

What defines Unstable Angina?

A
  • Chest pain now occurring at rest
  • Chest pain that is worsening in nature, such that it occurs easier, lasts longer, etc.
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9
Q

Besides EKG and Cardiac Enzymes, what are 2 other tests that can be done to assess coronary vasculature?

A
  1. Stress testing
  2. Coronary angiography
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10
Q

With stress testing is is either with exertion or?

A

Medication such as Dobutamine

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11
Q

With stress testing with medications, how does that work?

A

Diseased vessels are already maximally dilated so change will be seen in the non-diseased vessels

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12
Q

Prior to a stress test, what medications should be held for at least 48 hours? (3)

A

Beta blockers
CCBs
Nitrates

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13
Q

What is the mainstay of treatment for Stable Angina?

A

Aspirin
Beta blockers
+/- Nitroglycerin

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14
Q

What causes Prinzmetal Angina?

A

Coronary vessel vasospasm

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15
Q

How will Prinzmetal Angina present? In who?

A

Young women with chest pain that occurs at rest and often in the morning

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16
Q

How will Prinzmetal Angina present? In who?

A

Young women with chest pain that occurs at rest and often in the morning

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17
Q

What is the best treatment for Prinzmetal Angina?

A

CCBs!

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18
Q

Results of the EKG and Cardiac Enzymes for a NSTEMI?

A

EKG = normal
Cardiac enzymes = (+)

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19
Q

What is the full treatment for ACS?

A

MONA-B(ASH)
- Morphine
- O2
- Nitrates
- Aspirin + other Anti-platelets
- Beta blocker
- ACEi
- Statin
- Heparin

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20
Q

What is the full treatment for ACS?

A

MONA-BASH
- Morphine
- O2
- Nitrate
- Aspirin + Antiplatelet therapies
- Beta-blocker
- ACEi
- Statin
- Heparin

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21
Q

With a STEMI what can show up on an EKG? (4)

Study These Flashcards
A

ST elevations
NEW LBBB
+/- Q waves and T wave inversions

22
Q

When do Troponins and CK-MB peak?

Study These Flashcards
A

Troponins = 24-48 hours
CK-MB = Within 24 hours

23
Q

In what leads will an Inferior MI present? Vessel?

Study These Flashcards
A

Leads II, III, AVF
= Right Coronary A.

24
Q

What medications should you avoid if you suspect an Inferior MI and why?

Study These Flashcards
A

Nitrates because it will drop the BP since the RV is affected

25
In what leads will an Anterior MI present? Vessel?
V1 - V4 = Left Anterior Descending
26
In what leads will a Lateral MI present? Vessel?
Leads I, AVL, V5, V6 = Left Circumflex A.
27
In what leads will a Posterior MI present? What will you see?
ST depression in V1 and V2
28
IF PCI cannot be performed in less than ____ and theres no contraindications, administer _____
< 120 mins Give Thrombolytics = tPa, reteplase, streptokinase...
29
Day 1 following an MI, what are you worried about?
Heart failure
30
Days 2-4 following an MI, what are you worried about? (2)
Arrhythmias Pericarditis
31
Days 2-4 following an MI, what are you worried about? (2)
Arrhythmias Pericarditis
32
Days 5-10 following an MI, what are you worried about (3)?
LV wall rupture Papillary muscle rupture Septal rupture
33
Days 5-10 following an MI, what are you worried about? (3)
LV wall rupture Papillary muscle rupture Septal rupture
34
If LV wall ruptures, how will that present?
Like cardiac tamponade!
35
If a papillary muscle ruptures, how will that present?
Pulmonary edema Mitral regurgitation
36
If the septum ruptures, how will that present?
Increased oxygen in the RV
37
In the weeks to months following an MI, what are you worried about?
Ventricular aneurysm
38
In the weeks to months following an MI, what are you worried about?
Ventricular aneurysm
39
For Peripheral Arterial Disease, what are 3 mainstays of treatment not including Cilostazol?
Aspirin Statin Exercise therapy
40
How does Cardiac Tamponade arise?
- Fluid in pericardial sac - Increases the intracardial pressure - Decreased filling of the heart = Decreased CO
41
What will be present with Cardiac Tamponade?
JVD Distant heart sounds Hypotension Pulsus Paradoxus
42
What will be seen on EKG with Cardiac Tamponade?
Electrical alternans
43
What will be seen on Echo with Cardiac Tamponade?
RA and RV collapse
44
What virus commonly causes Pericarditis?
Coxsackie B
45
If Pericarditis occurs following an MI, what is the likely cause?
Autoimmune = Dressler syndrome
46
How will Pericarditis present?
Pleuritic chest pain and dyspnea +/- cough and fever
47
What will make the pain BETTER with Pericarditis?
Sitting up and bending forward
48
What may you hear on Auscultation with Pericarditis?
Friction rub throughout heart sounds
49
what will be seen on EKG with Pericarditis? (2 options)?
DIFFUSE ST elevation DIFFUSE PR depression
50
What is the treatment for Pericarditis?
Aspirin/NSAIDs + Colchicine +/- Steroids

COMAT - IM (17 decks)

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