Cardio Flashcards
What are the 2019 recommendations from the American Heart Association/American College of Cardiology (AHA/ACC) for ICD placement in ischemic heart disease ?
requirements for placement of an ICD for primary prevention of ischemic heart disease for patients with an ejection fraction ≤40%, no myocardial infarction in the previous 40 days, no revascularization in the previous 90 days, and with class I–IV NYHA function.
What are the 2019 recommendations from the American Heart Association/American College of Cardiology (AHA/ACC) for ICD placement in NON-ischemic heart disease ?
In persons with NON-ischemic cardiomyopathy, heart failure class I–III symptoms, and left ventricular ejection fraction ≤35% despite goal-directed medical therapy, an ICD is recommended or should be considered if meaningful survival beyond 1 year is expected (SOE=A).
What lifestyle changes can decrease blood pressure?
vegetarian diet; reducing alcohol and caffeine intake; increasing intake of fish oil, soy foods, and olive oil; increasing exercise; and, in overweight persons, losing weight. Weight loss is also possibly contributing to this patient’s low blood pressure.
What supplement can be used to decrease BP?
Approximately 40% of persons with hypertension are deficient in coenzyme Q10. There is evidence that over 4–12 weeks, coenzyme Q10 (at a dosage of 100–200 mg/d) lowers blood pressure in people with hypertension. Reductions of 6–19 mmHg systolic and of 2–16 mmHg diastolic were observed in four small, placebo-controlled trials. In four other studies comparing blood pressure before and after treatment with coenzyme Q10, systolic blood pressure decreased by 12–21 mmHg, and diastolic pressure decreased by 9–15 mmHg. The presumed mechanism of action for coenzyme Q10—preservation of nitric oxide in the endothelium—offers an approach to treatment of hypertension that is unique and distinct from pharmaceutical agents (SOE=B). (Option D)
What medications reduce CV events in DMII patients?
sodium-glucose cotransporter-2 (SGLT-2) inhibitor (eg, empagliflozin, canagliflozin, dapagliflozin) or a glucagon-like peptide-1 receptor agonist (GLP-1RA) (eg, liraglutide, semaglutide, dulaglutide). The trials included adults with hemoglobin A1c levels ≥7%; most were taking metformin at baseline. Thus, for adults with established kidney or atherosclerotic cardiovascular disease, or who are at high risk of atherosclerotic cardiovascular disease or heart failure, an SGLT-2 inhibitor or GLP-1RA is recommended as part of the glucose-lowering regimen, independent of hemoglobin A1c level (SOE=B)
What does improvement in EF with dobutamine infusion signify after suspected MI?
The improvement in ejection fraction on dobutamine infusion suggests that this patient has viable but ischemic myocardium.
Perfusion imaging, transesophageal echocardiography, and ventriculography are alternative techniques to assess myocardial viability (hibernating myocardium),
