Cardiac Medicine 🫀✅ Flashcards
1
Q
Two patients who have silent MI
A
Elderly women and TII DM
2
Q
Use of Killip Class
A
Used to stratify risk post MI
3
Q
Initial therapy for all ACS
A
MONA (morphine, oxygen if <94, nitrates, 300mg aspirin)
4
Q
List 5 meds all ACS survivors should be on, and 1 extras they may be on
A
Aspirin, another antiplatelet (p2y12 inhib), statin, beta blockers, ACEi’s. Maybe nitrate
5
Q
Antiarrythmics and other meds causing prolonged QT
A
Amiodarone, sotalol, class 1a’s, macrolides (except clarithromycin), TCAs, antipsychotics, chloroquine
6
Q
How to investigate and manage Torsades de Pointes
A
ECG. IV MgSO4
7
Q
After ACS, when do we give dual vs triple therapy.
A
Dual for 12 mo, or Triple for 6mo (only if PCI was done)
8
Q
What is in the dual and triple therapy (following ACS)
A
Dual: aspirin or cloppy (and) NOAC or VKA = 6mo
Triple: aspirin (and) Cloppy (and) VKA or NOAC = 3mo
9
Q
NSTEMI or unstable angina identified.
Management ?
A
MONA, then do GRACE score to determine if PCI best or not
10
Q
If GRACE score is </=3%. Do what?
A
Conservative management with Tiggy
11
Q
GRACE score of >3% and patient hemodynamically stable, do what?
A
PCI within 72hours, and prasgruel or tiggy, and UFH
12
Q
GRACE score >3% and patient hemodynamically unstable. mx?
A
PCI immediately. And prasgruel or tiggy, and UFH
13
Q
If a patient has a GRACE score less than 4%, yet is hemodynamically unstable… what do we do? (Unlikely scenario)
A
Do immediate PCI (stability takes priority)
14
Q
In NSTEMI/unstable angina, when is fondaparinux given?
A
If PCI not planned
15
Q
STEM I usually presents with how many minutes of pain
A
20 or more minutes
16
Q
In STEMI, we give dual antiplatelet therapy before PCI. Which dual antiplatelet drugs do we use (consider if patient is already taking oral anticoagulant)
A
If patient already taking oral anticoagulant give clopidogrel and aspirin. If patient not taking oral anticoagulant give prasgruel and aspirin
17
Q
If a patient has a STEMI, what determines whether they have a PCI or not
A
If PCI can be done within 120 minutes Then most likely should be done
18
Q
If cannot do PCI within 120 minutes, what is the alternative treatment for an STEMI
A
Fibrinolysis And antithrombin
19
Q
Which anti-platelet should be given alongside PCI
A
Prasgruel with Pci
20
Q
Following fibrinolysis, Which antiplatelet should be given
A
tiggy
21
Q
Three Cardinal features of angina pectoralis
A
Constricting discomfort in the chest, precipitated by exertion, relieved by rest or GTN
22
Q
Pass meds Answer for best investigation for angina (stable)
A
CT coronary angiography
23
Q
Aside from normal angina medication all patients should be taking which two medications
A
Aspirin and statin
24
Q
What medication can be taken to abort angina attacks
A
GTN
25
 Which two medications are considered first line for angina management
CCB and beta blocker
26
For angina if give CCB and beta blocker together, CCB must be which type
Dihydropyridine
27
In angina if a CCB is used as monotherapy, which CCB should be used
Verapamil or diltiazem
28
Cardio respiratory arrest – cardiac arrest. It’s usually down to which four rhythm disturbances
Ventricular fibrillation, pulseless ventricular tachycardia, pulseless electrical activity and asystole
29
Which investigations are important for cardiac arrest
Continuous cardiac monitoring. Then consider full blood count, electrolytes, ABG, x-ray, toxicology. Aside from ECG, this is all done after Mx
30
Management of cardiac arrest
ABCD, CPR (30 compressions then 2 breaths) for 5 cycles. Defib is shockable rhythm... recall
31
If defib doesn’t work for pulseless ventricular tachycardia/Vfib… can give what?
Amiodarone or Lidocaine
32
Best two invx for suspected endocarditis
Blood cultures and echo
33
Empirical antibiotics for endocarditis:
1. If native valve
2. If native valve but penicillin allergic
3. Severe sepsis
4. prosthetic valve
1. Amoxicillin (+/-) low dose gentamicin
2. Vancomycin and low dose gentamicin
3. Vancomycin and low dose gentamicin
4. Vancomycin and low dose gentamicin and rifampicin
34
Treatment of native valve staphylococcus endocarditis
Flucloxacillin (of vanco and rifampicin if penicillin allergic)
35
Prosthetic valve endocarditis due to staphylococcus treatment
Flucloxacillin and rifampicin and low dose gentamicin (vanco and rifampicin and low dose gentamicin if penicillin allergic)
36
Endocarditis due to fully sensitive strep (treatment)?
Benzylpenicillin (vanco and low dose gentamicin if allergic)
37
Endocarditis due to more resistant strep (treatment)
Benzylpenicillin (and a low dose gentamicin)
"Ben went to sRepton"
38
Monomorphic VT usually due to…
MI
39
Polymorphic VT usually due to what…
Prolonged QT
40
What do you see on an ECG in VT?
Wide QRS, regular rhythm, no p wave, and more than 100 bpm. And for >120ms
41
When do you cardiovert a patient with VT?
If patient has adverse signs, like SBP < 90, chest pain, HF
42
If a patient with VT presents, and has no ‘adverse signs’, how do you manage?
Antiarrythmics. Amiodarone IV is good, lidocaine ok (not if left Vent impaired), never Verapamil. If this doesn’t work, then can cardiovert
43
More than how many PVCs in a row = vent tachycardia
3
44
First Invx for VT and VF
ECG
45
Management for Vfib
Defib, and then an implantable cardioverter defibrillator (ICD)
46
Main risk factor for TdeP
Prologued QT
47
If suspect HF, do what Invx?
BNP
48
If BNP is high in suspected HF patient, do what to further Invx?
Trans thoracic echo
49
Management of acute HF (clue = like pulmonary edema)
IV furosemide, O2, vasodilators (unless hypotension), CPAP. And continue regular chronic HF meds
50
First line Invx for chronic HF patient
BNP
51
First line treatment (regime) for Chronic HF with preserved ejection fraction
ACEI and Beta Blocker (can add aldosterone antag. If still symptomatic)
52
Good add on for HF patients (black patients)
Hydralazine and nitrates
53
If cannot have Beta blocker in HF therapy… what can be used as a substitute
Ivabradine
54
If a patient with HF has widened QRS on ECG… how do you treat
Needs cardiac desynchronisation
55
HF patients Vx schedule
Annual influenza and one off pneumococcal
56
If intolerant to ACEI for HF management, use what?
ARB
57
If ACEi BB spirino are given for HF, and symptoms persist. Do what?
Replace ACEI with ARNI
58
If ACEi BB spirino are given for HF, and symptoms persist, whilst heart rate above 75. Do what?
Add ivabradine
59
Best investigation for pulmonary edema to find cause?
ECG (maybe)
60
investigations for pulmonary edema
Chest x ray (recall signs), ECG, oxygen, ABGs, BNP
61
Management of acute pulmonary edema
Oxygen with venturi, diuretics, morphine, nitrates
62
Considered high blood pressure
140/90
63
How to confirm diagnosis of hypertension
24 hour blood pressure monitor.
64
Why do we need to do and ECG in hypertension patients
Check for left ventricular hypertrophy or IHD.
65
Why should a urinalysis be done in patients with hypertension
To check for hypertensive renal disease
66
Stage 1 hypertension is?
>= 135/85
67
When do you treat stage 1 hypertension?
Treat if less than 80, and if there is target organ damage, CVD, renal disease etc
68
Most effective lifestyle change to decrease hypertension risks
DASH diet
69
What is stage 2 hypertension
>= 150/95
70
Do we always treat stage 2 hypertension
Yes
71
If a patient aged <40 presents with hypertension, what should be done/considered
Consider 2° hypertension and thus refer to specialist
72
Patient less than 55. Best drug for hypertension
ACEi
73
Patient over 55, best drug for hypertension
CCB
74
Black patient with hypertension. Best treatment?
CCB
75
Patient with T2 DM history. Best treatment
ACEi
76
If patient cannot tolerate ACEi cough, give???
ARB
77
4 first line treatments for hypertension
ACEi, ARB, thiazide, CCB
78
If patient on CCB, ACEi, thiazide (step 3), and K+ is less than 4.5. Can add what?
Low dose spirinolactone
79
If patient on CCB, ACEi, thiazide (step 3), and K+ is more than 4.5. Can add what?
Alpha or beta blocker
80
Black patient on CCB for hypertension, and needs step up. Give what?
ARB!
81
First degree heart block treatment?
NO treatment needed
82
PR interval has to be >? Seconds (>? Small squares) in first degree heart block
>0.2 Seconds (>5 Small squares)
83
Complete heart block is often due to what? (Related to MI)
RCA occlusion
84
Best invx to confirm heart blocks
ECG of course
85
Indications for pacemaker in heart block
Usually, 2°M II, and 3°. Or if symptoms severe (symptoms of respiratory acidosis )
86
WPW syndrome risk for what arrhythmia
VF
87
WPW is a type of ______ tachycardia
AV re-entrant tachycardia
88
3 findings of WPW on ECG
Short PR, delta wave, axis deviation (opposite to the pathway involved)
89
Definitive treatment for WPW
Radiofrequency ablation
90
Medical therapy for WPW? (First line). Then if you cannot use the first line?
That’s sooooo WPW. Sotalol (don’t use if Afib present).
Amiodarone and flecainude second line
91
More than __ ms (or __ small squares) is a long QT
440 ms or 10 small squares
92
Long QT can cause what arrhythmias
Torsades, VT or VF
93
Jervell Lange nielsen vs Romano ward
Jervell has deafness. Both are due to mutated potassium channels causing LONG QT
94
Investigation for long QT
ECG, echo, holster monitor, genetics test, electrolytes
95
Sotolol in prolonged QT?
No! Can prolongue it more
96
Management and treatment for prolonged QT
Avoid QT prolong drugs, avoid strenuous excserize; and ICD for high risk case
97
When do we give anticoagulant in AF. First line anticoagulant for AF? Why?
If CHADS VASc score says so. DOAC (apix, Dabi, edox, rivarox.) don’t need INR monitoring.
98
If patient has AF, and is stable. What meds should be given
Beta blocker or CCB (rate control) and a DOAC if CHAD VASc suggests to
99
When is cardioversion needed in AF
If patient is unstable
100
If the patient needs anticoagulant for AF, and has a valve disease. 1st line?
Warfarin
101
CHA2DS2 VASc stands for? Used for?
CHF, HTN, age > 75, diabetic, stroke history, vascular disease, age 65-74, Sex.
To assess need for anticoagulant I’m AF patients
102
CHADS VASc of 1 or more in man means?
Needs anticoagulant
103
CHADS VASc of 2 or more in woman means?
Anticoagulate
104
If patient has AF, and want to cardiovert. Started less than 48 hours ago. Do what?
Cardiovert .
Don’t worry about anticoagulating them first
105
If patient has AF, and want to cardiovert. Over 48 hours has elapsed. What options do we have to manage
Either anticoagulate patient for 4 weeks, then cardiovert. Or do transesophageal echo to check for thrombi in the atrial appendage
106
Paroxysmal AF definition
AF that terminates itself and lasts less than 7 days
107
Persistent AF, definition
Arrhythmia not self terminating and episodes last long than 7 days
108
Permanent AF, definition
Continuous AF, that cannot be cardioverted. Accepted as the final rate
109
Is the R-R interval regular in Afib or A flutter
A flutter
110
A flutter patient who is stable. Management?
Beta blocker or CCB
111
If want to ablate in A flutter, where to do this?
Tricuspid isthmus
112
If want to ablate a patient with a fib, where to do this?
Confluence of the pulmonary veins
113
Is a flutter more or less sensitive to cardioversion?
More, so can use lower energy levels
114
Difference between Afib and SVT
SVT is regular and has p waves (may be hard to see though).
115
Is supra ventricular tachycardia narrow or broad complex?
QRS is narrow
116
SVT 1st line management?
Carotid sinus massage or valsalva
117
Second line for SVT management. Tell me doses too
IV adenosine (6mg, then 12mg, then 18mg) (if the pervious didn’t work). if asthmatic, give verapamil instead
118
If patient had SVT and is unstable. How do you manage
Cardiovert
119
If you have a patient with SVT that is persistent to medical therapy. How do you manage?
cardioversion
120
How to prevent episodes of SVT
Beta blocker
121
Initial invx important for myocarditis suspicion
ECG (new ST and T wave changes), venupuncture for MB, troponin, BNP (all elevated), MRI is good!
122
Gold standard for Dx of myocarditis
Endomyocardial biopsy. MRI not bad either
123
Kaussmal sign is more seen in restrictive pericarditis or tamponade
Restrictive pericarditis
124
Pulses paradoxus is more seen in restrict pericarditis or tamponade
Tamponade (but technically both)
125
ECG changes for pericarditis
Saddle shaped ST elevation, in all leads. PR depression (sensitive)
126
All patients with suspected acute pericarditis, should have what invx done? (Aside from ECG)
Echocardiogram
127
First line and second line for pericarditis
NSAIDs and Colchicine
128
When should a pericarditis patient be hospitalised
Fever > 38°C
• Subacute onset
• Anticoagulated
• Immunocompromised
• Hypotension
• Jugular venous
distension
• Large effusion
(many signs of tamponade)
129
Mild mitral stenosis management
Diuretics
130
Moderate to severe mitral stenosis management
Valuable repair/ or valvotomy
131
To diagnose most/all valvulopathies, which invx should be done
Echo
132
Management of mitral valve prolapse
Antiplatlet therapy (aspirin) and mitral valve repair
133
Most common valve disease
AS (second is MR)
134
Potential ECG and X-ray findings in MR patients
Broad P wave (due to atrial enlargement). And cardiomegaly
135
Acute mitral regurgitation, management
Nitrates (increase forward flow), diuretics (decrease overload), inotropes, aortic balloon pump. Heart failure meds if the patient is in heart failure
136
Is repair or replacement better for MR
Repair
137
Aortic stenosis, asymptomatic patient. Valve pressure gradient <40. Mx?
Observe
138
Aortic stenosis, asymptomatic patient. Sign a of systolic dysfunction and Valve pressure gradient >40. Mx?
Consider Sx
139
Aortic stenosis, symptomatic patient. Mx?
Sx
140
What disease commonly coexists with AS? And thus prior to surgery, what can be done
CVD! So do an angiogram before Sx. Can combine surgeries
141
Best Sx for AS?
TAVI. Recall who gets metallic vs porcelain?
142
When do balloon valvuloplasty for AS?
If severe and cannot do replacement
143
Acute aortic valve regurgitation Mx
Emergency! Need to replace valve, but give inotropes and vasodilators first though
144
Chronic/asymptomatic AR Mx
Vasodilation (reduce the regurgitate)
145
Is WPW associated with HCM?
Yes!
146
What can be seen on the echo of a HCM patient? And an ECG?
MR, systolic anterior motion (SAM) of the anterior mitral valve, asymmetrical septal hypertrophy. Mega sokolovs seen on ecg
147
Why avoid nitrate, ACEI and inotropes on HCM?
All decrease preload and thus LVEDV (increases outflow obs)
148
How do you treat dilated cardiomyopathy?
Treat like HF (ACEI, beta blocker, diuretic
149
Important invx in shock patients
ABG (get lactate), BP monitoring, glucose,
150
Management of septic patient OU CALF
Oxygen admin (keep above 94), Cultures taken, Abx broach spec, Fluid resus (bonus 500ml crystalloid over less than 15 mins), Lactate measurements, Urine output hourly
151
Anaphylaxis management
Adrenaline (IM in thigh)
152
How many cm greater than normal aorta diameter is considered aneurysmal ?
3cm or more
153
Main risk factors for AAA
Smoking, HTN, atherosclerosis (not DM)
154
First line invx for AAA
US
155
Best invx for AAA
CT angio
156
How to manage a stable patient with AAA
CTA to assess suitability for endovascular repair.
157
How to manage an unstable AAA case?
Straight to theatre (Dx is clinical)
158
Suspected Tamponade. 2 Invx to do?
ECG and echo
159
A management of tamponade
Pericardiocentesis
160
Murmur for ASD
Ejection systolic murmur, and fixed split S2. Smaller ones are louder
161
Small ASD (pulm BF : systemic BF <1.5) Mx
No Tx needed
162
Large ASD (pulm BF : systemic BF >1.5) or rt atria enlarged Mx
Corrective closure
163
Murmur for VSD
Pansystolic murmur (louder=smaller)
164
Main consequence of large VSDs
Heart failure in months
165
Small asymptomatic VSD management
Close spontaneously usually… so monitor only
166
Treatment or larger VSDs/symptomatic VSDs
Surgical correction, and HF meds
167
S3 on <30 yo. Are you alarmed?
Not really, this is a normal finding here
168
Mild pulmonary stenosis treatment?
Follow up only
169
1st line treatment for moderate to severe pulmonary stenosis
Balloon valvuloplasty
170
Pulmonary stenosis patient who is cyanotic. What Medical management should he get?
Oxygen and PGE1. Even before diagnosing cause
171
If percutaneous balloon pulmonary valvuloplasty doesn’t work for patients with pulmonary stenosis… what can we do next
Surgical valvotomy
172
When do we do surgical repair for AR
If symptomatic or with LVEF of <50%
173
How can we medically delay surgery for AR patients
Vasodilator therapy
174
Signs of PDA
Parasternal systolic murmur becoming a continuous machine like murmur supraclavicularly.
Subclavicular thrill and collapsible pulse
175
Therapy to close a PDA
Indomethacin
176
When do you give PGE1 in PDA
If you want to keep the PDA open (maintain shunt)
177
Invx of choice for coarcted aorta
Echo to see the coarction. But best to do blood pressure measurements and radio femoral delay
178
A radio femoral delay of what or more, is concerning?
20mmHg
179
Transposition of the great vessels main risk factor
Maternal diabetes
180
Management of ToGVs?
PGE to keep PDA, then Sx
181
Tetralogy of fallout invx
Chest X-ray (boot), ecg (RV hypertrophy), echo
182
Medication to relieve cyanotic episodes in tet of fallot
Beta blocker
183
Examination sign for PAD
Absent dorsalis pedis and posterior tibial.
184
ABPI less than X, indicates PAD
1
185
ABPI < 0.5…. What does this mean?
Severe PAD, and needs urgent attention
186
Best invx for PAD
Doppler US
187
Edema, brown Pigmentation, eczema. These are all features of what kind of ulcer
Venous ulcer
188
Painful ulcers, with cold feet, no palpable pulses, low ankle brachial pulse index. These are features of ulcer
Arterial ulcer
189
Callous formation, ulcers on the plantar surface of the metatarsal head. Loss of sensation. These are features of what
Neuropathic ulcer ulcer
190
An ulcer above the ankle near the medial malleolus is most likely seen in which ulcer
Venous ulcer
191
Painful ulcers in the toes and the hill I’ll most likely scene in which ulcer
Arterial ulcer
192
Deep venous insufficiency is related to what other pathology
DVT
193
Superficial venous insufficiency is associated with which pathology
Varicose vein
194
What can be seen on ultrasound Dr , for venous leg ulcers
Reflux of blood
195
Management for venous leg ulcer
Four layer compression banding
196
Main management for neuropathic ulcers
Cushion shoes to reduce also formation
197
Two main causes of gangrene (two types of gangrene)
Infectious gangrene and ischaemic angry
198
What to tell you if the gangrene is ischaemic rather than infectious
A low ankle brachial pulse index
199
If a patient has gangrene and a low-grade fever and chills, is this likely ischaemic or infectious gangrene
Infectious
200
How to manage infectious gangrene
Aggressive surgical debridement and IV antibiotics
201
How to manage ischaemic gangrene
Revascularisation and treat the underlying disease
202
Diagnosed DVT, first line treatment
DOAC (apix or ribarox)
203
DVT suspected? Treatment?
DOAC! (Used to be heparin)
204
DVT patient, and cannot treat with DOAC
LMWH, followed by Dabigatran or Warfarin
205
Patient had anti phospholipid syndrome… and has DVT. How to Tx?
LMWH then warfarin
206
Anticoagulant for how long in unprovoked DVT?
6 months
207
Anticoagulant for how long in provoked DVT?
3 months
208
Which scores -2 on wells score?
Alternative diagnosis is more likely than DVT
209
Name as many scores on Wells
210
Wells of X or more, suggest DVT likely
2 or more
211
If Wells score of two points or more, next step management
Do proximal leg ultrasound within four hours. If cannot be done do d-dimer plus anticoagulation plus ultrasound within 24 hours
212
If a patient with a Wales score of two or more, has a negative proximal leg ultrasound, what investigation should be done next
Demon
213
If a patient has a wells score of one or less (for DVT ). Next step in management for patient
Do a D dimer within four hours
214
If a patient had a wells score of one or less and DD dimer came back positive, what should be done next
Proximal leg ultrasound
215
If patient had a Wells score of two or more, had a negative proximal leg ultrasound, but a positive D dimer. What should be done in this patient
Stop anticoagulation and repeat ultrasound in one week
216
An ankle brachial pulse index of 0.6-0.9 coincides with what symptom
Intermittent claudication
217
An ankle brachial pulse index of 0.3-0.6 coincides with what symptom
Pain at rest
218
If a patient presents with signs of acute limb ischaemia what investigation should be performed, and what should be calculated
Doppler ultrasound, and ankle brachial pulse index
219
Patient presents with acute limb ischemia. They have history of widespread vascular disease, and a history of claudication that has now suddenly deteriorated. Is it likely thrombus origin for embolus origin
Thrombus origin
220
Patient presents with acute limb ischemia. They have no history of claudication, no history of peripheral vascular disease but a recent atrial fibrillation. Is this likely thrombus origin or embolus origin
Embolus origin
221
Initial management for acute limb ischaemia
ABC, IV opioids, IV unfractioned heparin (chubby guy was right)
222
Some definitive management for acute limb ischaemia
Thrombolysis, embolectomy, angioplasty, bypass surgery, amputation if irreversible
223
First line investigation for chronic limb ischemia
Ultrasound with the Doppler
224
Aside from ultrasound, which investigation must be done prior to treatment for chronic limb ischaemia
Magnetic resonance angiography
225
What antiplatelet therapy can be used for chronic limb ischaemia
Aspirin or clopidogrel
226
In aortic dissection what does anterior versus back pain signify
Backpain signifies descending aorta dissection, anterior chest pain signifies ascending aorta dissection
227
Diagnosis of an aortic dissection is made by what (if patient is stable)
CTA
228
Definitive treatment for coarctation of the aorta
Angioplasty or surgical resection
229
If an aortic dissection patient is unstable, how do you investigate them
Trans-oesophageal echo, cannot do CT Angio in unstable patience
230
Investigation of choice for varicose veins
Ultrasound with Doppler, Can see venous reflux
231
Majority of patients do not require surgery for varicose veins. Name some conservative treatments
Leg elevation, weight loss, exercise, compression stockings
232
Name five reasons for referral to secondary care in varicose vein patients
Significant pain or swelling, previous bleeding, skin changes, thrombophlebitis, healed or active ulcer
233
Name three invasive treatments for varicose veins
Foam sclerotherapy, location or stripping surgery, and a thermal ablation using laser
234
NSAIDs for myocarditis?
NO, CI
235
Ischemic gangrene Mx if not too bad
Heparin
236
Ischemic gangrene with threatened non viability
Revasc
237
DVT stuff. What is the timeframe for doing dopplers and d dimers
238
stable patient with aortic dissec... invx?
CTA
239
unstable patient with aortic dissec... invx?
TOE
240
A flutter (how to tell?)
regular RR!! Can be hard to tell from afib and heart block
241
Troponin time frame
Rises in 2-4 hours. Falls after weeks
242
CK-mB time frame in MI
Rises in 4-6 hours. Falls after 48 hours
243
Mx for shockable cardiac arrest
shock, 2 mins CPR.... repeat. Do epinephrine after 3 shock
244
Mx for non-shockable cardiac arrest
adrenaline, 2 mins CPR.... repeat
245
HF patient. On ACEi, BB, Aldo antag. HR below 75... give what?
ARNI
246
HF patient. On ACEi, BB, Aldo antag. HR above 75... give what?
Ivabradine
247
HF patient. On ACEi, BB, Aldo antag. Black patient... give what?
hydralazine and nitrate
248
At what EF, does HF pharmacy start
around <40
249
When to focus on rate control only in AF?
Chronic/permanent A, patient stable
250
First onset stable AF, how to Tx?
Rhythm control = flecainide 1st (amiodarone 2nd)
251
Best invx for takutsobu
ventriculography
252
ABPI calc
ankle/brachial SBP
253
How long is the ischemic clock in acute limb ischemia?
6 hr
254
Difference between acute limb ischemia in femoral, iliac, aortoiliac
255
Afib vs 3rd degree AV block
p wave in 3rd degree. tachycardia in afib
256
myocarditis Mx
rest and monitor
257
HF with <35% EF... do what?
do angiogram to see if ischemic CM or not
258
NSAIDS or CCB in HF?
NO
259
When to thrombolyse patient with PE
if patient has low BP
260
severe AS in older patient... best Tx
TAVI
261
if patient with NSTEMI has HF, or low BP, or VT, or ongoing angina..... sign to do what?
angiogram and PCI to be done sooner! (all our GRACE)
262
if NSTEMI patient has good EF/heart function... what to do
conservative (tiggy and fonda)
263
when to do medical cardioversion in AF
in first 48 hours!!!
264
Weird ECG is likely what??
3rd degree
265
if do echo on patient with pericarditis... see fluid... what to do?
measure fluid then drain if large or tamponade
