Cardiology 1 Flashcards
What cardiac condition produces TH17 which produces mRNA?
Dilated cardiomyopathy
Acute myocarditis
DAPT duration for; BMS? DES -Sirolimus -Paclitaxel
BMS - 3 months minimum
DES - 12 months ideally
-sirolimus - 3 months
-Paclitaxel - 6 months
What anti-lipid treatment that increases TGL?
What anti-lipid treatment that increases HDL the most?
Cholestyramine
Gemfibrozil
Asymptomatic people without cardiovascular risk - aspirin role?
High lipid, and increased cardiovascular risk - statin role?
NO ROLE
NO ROLE
-except high Ca score > 100
Preload and Afterload definition?
Balloon analogy
Preload = end-diastolic pressure of LV/RV = ventricles filling prior to contraction
Afterload = systemic vascular resistance = force ventricles need to eject and overcome to open the aortic valve
Ezetimibe MOA?
blocks NPC (cholesterol absorption channel)
Target LDL for ;
Established CVD
Established CVD : < 1.8
high risk - < 1.5
When use PCSK9 inhibitor (Evolucumab)?
Statin for 12 months + Ezetimibe for 3 months
+ pharmacological management
AND
LDL > 1.8
PCSK9 function?
bind to LDLR (receptor) and degrade it so more LDL in circulation
*LDLR binds to LDL and remove it from circulation
Familial Hypercholesterolemia -Dutch criteria?
Family hx of Tendon xanthomata/ corneal arcus Having tendon xanthomata/corneal arcus Premature CVD LDL levels high PCSK9 gene/LDLR mutation
Optimal medical therapy for angina?
SABAS
Sublingual nitrates ACEI = *LVDF < 40% + CKD/DM B-blocker = LVDF < 40% + prior MI Aspirin Statin
LMWH blocks what action?
UFH blocks what action?
FXa
FXa + Thrombin (II)
UFH associated with what and how to monitor to prevent it?
HITS - aPTT monitoring
Which type of CAD carries worst prognosis?
Left Main CAD
What are the complications of PCI?
Cardiogenic shock/ Heart failure - use IABP
Arrhythmias
Anticoagulant has least bleeding rate and chance of causing HITS?
Fondaparinux
ARNI inhibit nephrolysin via what channel?
LBQ657 = degrades bradykinin = causing vasodilatation, diuresis, relaxation
When use ARNI?
EF < 35% + NYHA class II - IV
Where is the ‘funny channel’ = IF located?
SA node
ICD insertion indications? ( 4 Is)
Ischemic cardiomyopathy
Intractable Ventricular arrhythmias
NYHA II - III
lvEF < 35% despite medical therapy for 3 months
CRT indications?
NYHA II - III
lvEF < 35% despite medical therapy for 3 months
QRS > 130 ms + LBBB
Heart transplant indications? ( 4 Vs)
Vo2 max < 14
Vascular ischemic - needing inotropes
Ventricular arrhythmias
V-IV NYHA
Late complication of heart transplant?
Chronic allograft arteriopathy - hence 6 months routine angiography
-luminal stenosis > 40% - you’re fucked
What’s so special about sotagliflozin?
SGLT 1 and 2 inhibitor
can be use in HF - preserved or reduced EF
Flecainide cannot be used in those with structural heart disease - why?
Negative inotropic effect
ARVD
- best imaging?
- best treatment?
- happens in?
Imaging - MRI - review RV thickness and function
Treatment - B-blockers +/- ICD
Exercise is associated with it
Verapamil cannot be used in what condition and why?
VT/ Wide QRS complex
-inhibits Ca2+ entry into L type channel = severe hypotension and cardiac arrest
Idiopathic VT causes?
Diastolic Ca overload - delayed after depolarisation
SVT in RBBB - what it shows?
SVT with normal RBBB morphology!
SVT in LBBB - what it shows?
Small R waves, absence Q waves
