Cardio Flashcards
Atherosclerosis is
Athermatous plaques forming in artery walls
Atherosclerosis plaques result in (3)
Stiffening
Stenosis
Plaque rupture
Stiffening in atherosclerosis leads to
HTN
Stenosis in atherosclerosis leads to
Angina
Plaque Rupture in atherosclerosis leads to
MI etc
Start a statin first check
LFTs
Statin ADRs
Myopathy, rhabdomyolysis
After a MI, offer patients
Dual antiplatelets
Aspirin 75 mg
Clopidogrel or Ticagrelor
Generally for 12 months
Angina is stable when
Symptoms come on with exertion only, and always relieved by rest or GTN
Angina is unstable when
Symptoms appear randomly whilst at rest
- type of acute coronary syndrome and require immediate management
Patients with angina should have which investigations (6)
Physical examination (cardio, BP, BMI), ECG, blood tests
Cardiac stress testing
CT coronary angiography
Invasive coronary angiography (gold standard)
GTN ADRs
dizziness and headaches
long-term symptomatic relief of stable angina medications (2)
B-blocker (bisoprolol)
CCB - diltiazem or verapamil - avoid in HF
MI prevention thrombus med
Aspirin
Surgical interventions for angina
Percutaneous coronary intervention, Coronary artery bypass graft.
Three types of acute coronary syndrome
Unstable angina
STEMI
NSTEMI
ACS Investigations
Troponin, baseline bloods
ECG
CXR
Echocardiogram - once stable - to assess functional damage to the heart.
Troponin specific?
Troponin is a non-specific marker, meaning that a raised troponin does not automatically imply acute coronary syndrome. The alternative causes of a raised troponin include:
Chronic kidney disease
Sepsis
Myocarditis
Aortic dissection
Pulmonary embolism
STEMI management
PCI (within 2 hrs)
Thrombolysis
Complications of MI
Death
Rupture
oEdema (Heart failure)
Arrhythmia
Dressler’s syndrome
Dressler’s syndrome
2-3 weeks after acute MI, localised immune response resulting in inflammation of pericardium - pericarditis.
Pleuritic chest pain, low grade fever, pericardial rub on auscultation.
Dressler’s syndrome complications
Pericardial effusion and rarely pericardial tamponade
Dressler’s syndrome management
NSAIDs, steroids, pericardiocentesis if needed.
Pericarditis
idiopathic, infective - viral mostly.
Also autoimmune (RA, SLE), injury, uraemia, cancer