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EM 1 > cardiac emergencies > Flashcards

cardiac emergencies Flashcards

1
Q

CAD risk factors (6)

A
  • over 40 yo, male or postmenopause
  • hypercholesterolemia
  • DM, obesity, HTN, sedentary
  • fam hx
  • tobacco, cocaine
  • HIV infection
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2
Q

use of CXR in chest pain

A

to r/o other causes like pneumonia, pneumothorax

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3
Q

aortic dissection, PE would be seen best on what kind of imaging

A

CT angiography

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4
Q

what kind of radiography would be good for low risk ACS

A

coronary CTA

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5
Q

D-dimer is gotten to r/o what?

A

PE

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6
Q

4 HEART risk fx:

A
  • HTN, hypercholesterolemia
  • DM, obesity (BMI >30 kg/m²)
  • smoking (current, or smoking cessation ≤3 mo)
  • positive family history (1st deg. with CVD before age 65)
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7
Q

HEART risk score (low vs intermediate vs high)

A
  • low is 0-3
  • intermediate is 4-6
  • high is 7+
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8
Q

leading cause of adult mortality in the US

A

ACS

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9
Q

chest pain w/ no clear alternative cause, and no clear evidence of cardiac injury or stress on ECG and biomarker tests

A

low probability ACS

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10
Q

chest discomfort lasting short amount of time; provoked with exertion/stress

A

stable angina

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11
Q

rest angina, prolonged >20 mins
new onset angina w/ significant physical limitation
previously diagnosed angina becoming longer or more often

A

unstable angina

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12
Q

what med should be avoided with stable angina

A

NSAIDs

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13
Q

you do not use nitroglycerin for what type of MI

A

inferior wal MI

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14
Q

2 tx options for STEMI less than 12 hrs

A
  • PCI
  • fibrinolytics
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15
Q

IABP is used for ____ or ____

A

acute MR or RV infarct

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16
Q

nitroglycerin, nitroprusside, loop diuretics are used for afterload reduction in ____tensive HF

A

HYPER

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17
Q
  • Airway, ventilation, oxygenation
  • noninvasive ventilation early, and sit patient upright!
  • Nitroglycerin (BP > 150/100) - Reduce BP by 20%–30%
A

acute pulmonary edema management

18
Q

when do you use nitroprusside in acute pulmonary edema

A

If elevated BP, persistent sx despite Max IV Nitro

19
Q

Dx– endocardial biopsy is gold standard, ECG changes, troponin elevation, cardiac MRI

A

myocarditis dx

20
Q

classic ECG findings of
* PR segment depression
* Diffuse ST elevations
* low voltage QRS
* Electrical alternans– think tamponade

A

pericarditis

21
Q

which imaging is diagnostic for pericarditis

A

echo

22
Q

which HEART score gets admitted with low probability ACS

A
  • 4-6
23
Q

which HEART score gets early revascularization with low probability ACS

A

7+

24
Q

you should avoid what med class in AR unless its from an aortic dissection

A

BB

25
Q

sudden onset of 6 Ps, normal contralateral limb

A

embolic acute limb ischemia

26
Q

6Ps of acute limb ischemia

A

pain
pallor
paralysis
pulseless
paresthesia
polar

27
Q

4 chronic risk factors of occlusive PAD

A
  • Age, smoking, diabetes, hyperlipidemia
28
Q

ABI values for chronic vs life threatening occlusive PAD

A
  • chonic < 0.9
  • life threatening < 0.25
29
Q

ways to manage occlusive PAD

A
  • Vascular surgery consult
  • Unfractionated heparin
  • Aspirin 325 mg
  • Pain control
  • Environment protection
  • Vascular surgery
30
Q

what does this describe:

intima violation, blood into media and dissects btwn intima and adventitia, creating false lumen

A

aortic dissection

31
Q

what does this describe:

intima violation, blood into media and dissects btwn intima and adventitia, creating false lumen

A

aortic dissection

32
Q

Sudden onset severe, sharp or ripping/tearing chest pain radiating to back b/w scapulae

this is the general descriptor for what?

A

aortic dissection

can have sx of stroke, anterior cord syndrome, Horner’s syndrome

33
Q

____ tension is more common in aortic dissection while ____ tension is more common in AAA

A
  • hyper— dissection
  • hypo— AAA

if hypo in dissection, thats a bad prognosis

33
Q

____ tension is more common in aortic dissection while ____ tension is more common in AAA

A
  • hyper— dissection
  • hypo— AAA

if hypo in dissection or new AR, thats a bad prognosis

34
Q

two imaging in evaluating aortic dissection and what are their findings

A

CXR: widened mediastinum
CTA: evaluate anatomy

35
Q

Severe abrupt onset back pain, abdominal pain, flank pain, +/- syncope, shock, ischemic limb

A

AAA

36
Q

HR and SBP goals when reducing shear force in aortic dissection

A

HR under 60
BP under 160 (ideally 100-120)

37
Q

first 2 med to give in aortic dissection

A
  • esmolol bolus + drip
  • labetolol bolus + PRN

they are negative inotropes/BB

38
Q

2nd two meds to give in aortic dissection that can be given first to avoid reflex tachycardia?

A
  • Nitroprusside
  • Nicardipine

vasodilators given PRN

39
Q

which type of aortic dissecton is tx with medical management unless refractory

A

type B

40
Q

which type of aortic dissection is tx emergently

A

type A or complicated B

EM 1 (5 decks)

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