Cardio Flashcards
best initial test for chest pain
EKG
(1) and (2) on EKG indicate a current STEMI
1- >2mm ST elevation
2- new LBB (wide, flat QRS)
what EKG findings are seen in a STEMI with a new LBBB
wide, flat QRS
describe the timing of the EKG changes seen in MI (hint- 3)
Immediately- ST elevation
6 hrs- T wave inversion
Forever- Q waves
Dx for patient presenting with hypotension, tachycardia, clear lungs, JVD, and no pulsus paradoxus
R MI
describe R MI presentation
hypotension, tachycardia, clear lungs, JVD (+ no pulsus paradoxus)
how do you treat R MI
vigorous fluid resuscitation
DO NOT GIVE NITRATES
after ECG, _____ is the next best test for evaluating chest pain (indicate required amount of testing)
Cardiac Enzymes: (myoglobin), Troponins, CK-MB
-must take at least 3 sets
Indications for CABG:
1) ?
2) ?
3) ?
4) >70%% occlusion
5) pain despite max medical Tx
6) post-infarction angina
1) L main disease
2) 3 vessel disease
3) 2 vessel disease + DM
Indications for CABG:
1) L main disease
2) 3 vessel disease
3) 2 vessel disease + DM
4) ?
5) ?
6) ?
4) >70%% occlusion
5) pain despite max medical Tx
6) post-infarction angina
to evaluate Unstable Angina, ____ is usually performed
exercise EKG
what meds must be avoided before doing an Exercise EKG
(do not take w/in 24hrs)
β-blockers
CCBs
nitrates
list the indications to perform a stress ECHO instead of a stress EKG
- old LBBB
- baseline ST elevation
- taking digoxin
chemical stress test in people who can’t exercise is administered using….
dobutamine OR adenosine
MUGA / nuclear stress test shows (1)
Note- (2) and (3) must be avoided before
1- heart perfusion
2- caffeine
3- theophylline
most common cause of death post-MI
arrhythmias- re-entrant V-fib
new systolic murmur 5-7 days post-MI
papillary muscle rupture –> mitral regurgitation
acute severe hypotension 5-14 days post-MI
ventricular free wall rupture (also has Cardiac Tamponade features)
“step-up” in [O2] in RA –> RV post-MI
ventricular septal wall rupture (also new holosystolic murmur)
persistent ST elevation 1 mo post-MI + systolic MR murmur
ventricular wall aneurysm
describe Tx for:
(1) peri-infarction pericarditis
(2) Dressler’s
1- supportive (nsaids may cause cardiac scarring)
2- NSAIDs + ASA (autoimmune pericarditis)
‘cannon A waves’ indicate….
AV dissociation: V-fib, 3rd degree heart block
describe EKG findings in Multi-focal Atrial Tachycardia
- varying PR interval
- 3 or more morphologically distinct P waves in the same lead
what is the disease with an EKG showing varying PR intervals with at least 3 morphologically distinct P waves in the same lead
Multi-focal Atrial Tachycardia
describe Tx for SVT
1) carotid massage (kids- head in ice water)
2) adenosine
ACE-i prevent cardiac remodeling by blocking (1)
β-blockers prevent cardiac remodeling by blocking (2)
1- aldosterone
2- NE/Epi
