Cardio Flashcards
Hypertension <55 year-olds
- ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
- CCBs (Amlodipine, Nifedipine, Verapamil, Diltiazem)
- Thiazide Diuretics (Bendroflumethiazide)
- Beta-Blockers (Atenolol, Bisoprolol)
or Alpha-Blockers (Prazosin, Doxazosin)
or Spironolactone
Exchange ACE Inhibitors for Angiotensin Receptor Blockers (Losartan, Valsartan, Candesartan)
Hypertension > 55 year-olds or Black patients
- CCBs (Amlodipine, Nifedipine, Verapamil, Diltiazem)
- ACE Inhibitors (Ramipril, Lisinopril, Perindopril)
- Thiazide Diuretics (Bendroflumethiazide)
- Beta-Blockers (Atenolol, Bisoprolol)
or Alpha-Blockers (Prazosin, Doxazosin)
or Spironolactone
Exchange ACE Inhibitors for Angiotensin Receptor Blockers (Losartan, Valsartan, Candesartan)
Targeted additional therapies for Hypertension
Angina: BBs and CCBs (never together) Heart Failure: BBs and ACE Is Diabetic Nephropathy: ACE Is and ARBs Prostatism: Alpha-Blockers Elderly: Thiazide Diuretics
Angina
ABC BAGS P
Aspirin
B1-Blockers (Atenolol, bisoprolol, metropolol) C
CCBs (Amlodipine, Nifedipine, Felodipine) B
Bypass
Angioplasty
GTN
Statins (if choleosterol >5mm/L)
Potassium Channel Openers (nicorandil, minoxidil)
Unstable: Old ladies are unstable, HAG
- IV Heparin
- Aspirin
- IV GTN
Coronary Artery Spasm:
- CCBs
- Isosorbide mononitrate
Heart Failure
Acute: Remember to be SOFD
- Sit up
- Oxygen
- IV Furosemide
- IV Diamorphine (not in COPD)
Standard therapy (or previous MI): ABDDS
- ACEi
- B-Blockers
- Diuretics
- Digoxin
- Spironolactone
Cor Pulmonale:
- Diuretics
- Oxygen
Valvular Disease:
- Surgery
AF:
- Digoxin
- DC Cardioversion
Acute Pulmonary Oedema
Furosemide
DVT
DVTS happen Lower than the Waist
Anticoagulation:
- LMWH
- Warfarin (not in pregnancy)
TED compression stockings
Phlegmasia Dolens
DVT caused obstruction of arterial flow due to back pressure created
IVC filter through femoral artery which prevents thrombus entering lungs (PE prophylaxis)
- if long term give anticoagulation (as IVC increases DVT risk)
Limb Ischaemia
A sudden lack of blood flow to a limb- causing intermittent claudication, ulcers or gangrene
You can’t go skiing in the ALPS if you have limb ischaemia
Anti-platelets
Lifestyle change (stop smoking, exercise more)
PCI or vascular bypass
Statins
Abdominal Aortic Aneurysm
Defect in collagen-elastin regulation, causing excessive dilation + increase in abdominal aortic wall stress
Endovascular Aneurysm Repair
(Stent inserted via groin and passed up until the weakened part of the artery aneurysm is reached, where it seals off the aneurysm from inside the artery)
Varicose Veins
Back pressure due to incompetent valves causes blood to pool in superficial veins
Foam sclerotherapy (chemical thrombophlebitis) Endovenous ablation Compression stockings
Stroke
(Disrupted blood supply to the brain, causing ischaemia and focal neuropathy)
2 Types:
- Ischaemic: Thrombus (blood clot)
- Haemorrhagic: Hypoperfusion from bleed (aneurysm)
Strokes happen in the brain, must be smart, probably got decent SATS
Ischaemic: SATS
- Statins
- Aspirin
- Thrombolysis (tPA)
- Supportive
Haemorrhagic:
- supportive
Admit to Stroke Unit obvs
Anti-hypertensives
Acute STEMI
Patient is probably moaning bc they are having an MI
MONA C Morphine (give with anti-emetic) Oxygen obviously Nitrate Aspirin Clopidogrel
PCI within 90 mins, or else thrombolysis
Can use:
B1-Blockers (Metroprolol)
Post-MI
SABA + C Statin ACEi Beta Blocker Aspirin \+ Clopidogrel for 4 weeks
CCBs (Verapamil, Diltiazem) in place of B-Blockers
Warfarin in place of Aspirin & Clopidogrel
Supraventricular Arrhythmias
3 Types:
- AF
- Atrial Flutter
- Ectopic Atrial Tachycardia
VAV Vagal manoeuvres (Hold breath, bear down, equalise) Carotid massage (usually in children with low stroke risk) IV adenosine (Anti-arrhythmic) IV verapamil (CCB)
Unstable: DC Cardiovert
Chronic Arrhythmias
Radiofrequency Ablation
Selective cauterisation of cardiac tissue to prevent tachycardia- all anti-arrhythmic drugs must be stopped prior
Ventricular Tachycardia
Acute (unstable): DC Cardioversion
Paroxysmal (stable): Amiodarone
If unsure if its VT /SVT give Adenosine (Anti-arrhythmic)
Atrial Fibrillation
ABCDD
- Amiodarone (Anti-arrhythmic) - rhythm control
- B1- Blockers (Atenolol, Bisoprolol, Metropolol) - rate
- CCB (Verapamil, Diltiazem) - rate control
- Digoxin (Anti-arrhythmic) - rate control
- DC Cardioversion - rhythm control
Anti-coagulation
Maze procedure
Pulseless VT
Shock that mofo tf (defibrillation)
Ventricular Fibrillation
Did someone say clear? SHOCK EM’ (defibrillation)
Consider adenosine if unsure
Asystole
Patient is fucked
Adrenaline 1mg IV every 3-5 mins following CPR
Atropine
Intubation and IV access
Pulseless electrical activity
Patient est fuckéd
CPR
IV access for: Atropine, Vasopressin, Adrenaline
Oxygen and intubation
Pray
Aortic Stenosis
Valve replacement
Balloon valvotomy
TAVI (valve implantation)
Mitral Regurgitation
Valve replacement Percutaneous mitral valve repair Loop Diuretics (Furosemide) ACE Is (Ramipril, Lisinopril, Perindopril) Digoxin Warfarin
