Cardiac Causes Of Cardiac Arrest

Question 1

What is ACS

Answer 1

A group of clinical conditions which present with chest pain / discomfort resulting from ischaemia

Question 2

Run through algorithm for ACS

Answer 2

Question 3

What is the usual cause of angina?

Answer 3

Usually myocardial ischaemia, mostly caused by obstructive CAD

Question 4

What is unstable angina?

Answer 4

Unprovoked or becoming more common with less and less activity

Question 5

An ECG with angina can show?

Answer 5

Question 6

Do you need to wait for troponin with stemi?

Answer 6

No

Question 7

What are high risk rhythm that may develop with stemi

Answer 7

VT, VF, or dead rhythm

Question 8

Changes in v1-v4 are what and which artery?

Answer 8

Anterior infarction with the LCA and extension into v5 & v6 is anterolateral

Question 9

What leads are inferior infarction seen?

What artery?

Answer 9

ii, iii, avf

RCA

Question 10

Lateral infarction, what leads and what artery?

Answer 10

v5, 6, i, avl

Circumflex and LCA (diagnol branch)

Question 11

What is the immediate tx of all ACS?

Answer 11

12 lead ECG
Aspirin 300mg
O2 94-98%
Gtn (unless shocked)
Analgesics - IV opiate

Question 12

If within 12 hrs of sx onset of stemi, what to do immediately?

Answer 12

PCI

Or

Fibrinolytic

Beyond 12 hrs, it can be done if signs of continuing ischaemia

Question 13

Call to Balloon time?

Answer 13

< 60 to 90 minutes

Question 14

What meds should be given aside from aspirin with ppci?

Answer 14

Anticoagulant like clopidogrel, ticagrelor, prasugrel

In the lab, heparin and maybe glycoprotein in high risk patients

Question 15

What is the algo for reperfusion of stemi?

Answer 15

Question 16

Contraindications for fibrinolytic tx

Answer 16

Question 17

What sort of rhythm can show reperfusion?

Answer 17

Accelerated Idioventricular

Question 18

If fibrinolytic fails or 12 lead doesn’t show at elevation resolving by more than 50%, then what?

Answer 18

Ppci is needed

Question 19

If fibrinolytic fails or 12 lead doesn’t show at elevation resolving by more than 50%, then what?

Answer 19

Ppci is needed

Question 20

Nstemi tx?

Answer 20

Heparin, aspirin 300mg loading then 75 mg daily, adp blocker like clopidogrel, beta blocker / diltazem to reduce myocardial oxygen demand, nitrates, maybe ace i

Question 21

To preserve left ventricular function after ami, what drug

Answer 21

Ace inhibitor (reduces remodel) and beta blocker (size of infarction)