Cardiac Part 1 Flashcards
What is required for the diagnosis of myocardial infarction?
Rise and/or fall of cardiac biomarkers with at least one value > 99th percent of upper limit reference range AND >1 of the following:
* Ischemic symptoms
* New ischemic ECG changes
* Image evidence of nonviable myocardium
* Imaging showing new regional wall motion abnormalities
These criteria help in confirming the diagnosis of MI.
What distinguishes ST-elevation myocardial infarction (STEMI) from non-ST-elevation myocardial infarction (NSTEMI)?
STEMI is characterized by easily identified coronary lesions and benefits from emergent intervention, while NSTEMI usually has multiple coronary lesions and requires coronary angiography within days of symptoms.
STEMI and NSTEMI differ in terms of immediate treatment options and the nature of coronary lesions.
What are the types of myocardial infarctions?
Types of myocardial infarctions:
* Type 1: Spontaneous, related to primary events like plaque erosion or rupture.
* Type 2: Related to imbalance between myocardial oxygen supply and demand.
Type 1 can lead to STEMI or NSTEMI, while Type 2 typically leads to NSTEMI only.
What is the significance of sustained troponin elevation in chronic heart failure?
In chronic heart failure, sustained troponin elevation is often observed, while acute heart failure is typically accompanied by acute troponin release.
This distinction helps in understanding the underlying heart conditions.
What is the recommended duration for dual antiplatelet therapy (DAPT) after angioplasty with drug-eluting stents?
6 months DAPT if no myocardial damage occurred.
This duration is critical to prevent stent thrombosis.
What preoperative assessments are indicated for patients with known coronary heart disease?
Preoperative ECG is indicated for:
* Known coronary heart disease
* Significant arrhythmia
* Peripheral arterial disease
* CVA
* Significant structural heart disease
These factors help assess the risk of perioperative myocardial infarction.
What does the New York Heart Classification assess?
It categorizes heart failure based on the degree of functional limitation.
This classification helps in understanding the severity of heart failure.
What laboratory findings can indicate heart failure?
Natriuretic peptides (BNP):
* 0-100 pg/mL = HF unlikely
* 400 pg/mL = HF likely
BNP levels are essential in diagnosing heart failure.
What are the common differential diagnoses for heart failure?
Differential diagnoses include:
* Myocardial infarction
* Chronic lung disease
* Pneumonia
* Anemia
* Pulmonary embolus
* Deconditioning
* Depression
* Sleep disorder breathing
These conditions can mimic heart failure symptoms.
What is the management of hypertension in the context of surgery?
Hypertension should be treated cautiously prior to surgery to avoid adverse outcomes.
Aggressive treatment just before surgery can lead to complications.
What is the most common type of stenotic valvular disease?
Aortic stenosis is the most common type of stenotic valvular disease.
It often requires surgical intervention.
Fill in the blank: The _______ is characterized by a high-pitched holosystolic murmur.
Aortic regurgitation
This murmur is a key clinical finding in patients with aortic regurgitation.
What is a key consideration for patients undergoing elective surgery after angioplasty?
Consult with prescriber regarding antiplatelet therapy, completeness of revascularization, and other factors.
These considerations impact surgical outcomes.
True or False: Routine echocardiography is recommended for preoperative assessment.
False
Echocardiography is not useful for evaluating CAD or predicting perioperative MI.
What are the two types of heart failure classified by left ventricular ejection fraction?
Heart failure with:
* Preserved ejection fraction (Diastolic HF)
* Reduced ejection fraction (Systolic HF)
These classifications aid in diagnosis and treatment strategies.
What is the objective of preoperative evaluation in heart failure patients?
Objectives include:
* Assess current degree of compensation
* Determine underlying cause of HF
* Identify coexisting conditions
* Exclude new HF diagnosis
* Confirm adherence to therapies
A thorough evaluation is crucial for optimal management.
What is the management approach for arrhythmias in heart failure patients?
Management includes:
* Treatment of hypertension
* Heart rate control
* Management of arrhythmias
These strategies are essential for reducing morbidity and mortality.
