CARDIOLOGY Flashcards
What is most common cause of death following an MI?
Cardiac arrest due to VF
What medications can improve the long-term prognosis of patients with chronic heart failure?
ACE-i’s
Bete-blockers
What type of arrhythmia is common following an inferior MI?
AV block
When do patients develop pericarditis post-MI?
48 hours
When does Dressler’s syndrome occur?
2-6 weeks following an MI
What are the features of Dressler’s syndrome?
fever, pleuritic pain, pericardial effusion and a raised ESR
What is seen on an ECG in a left ventricular aneurysm (post-MI)?
Persistent ST elevation
Left ventricular failure
Patients should be anti coagulated
What is the primary prevention of cardiovascular disease?
QRISK score >10% = offer a statin
All patients with CKD/T1DM >10 years should be offered a statin
When should lipids be checked after starting a statin?
Baseline
3 months - aim for 40% reduction in non-HDL cholesterol (always check adherence before increasing the dose)
What is secondary prevention for cardiovascular disease?
4A’s
A – Aspirin (plus a second antiplatelet such as clopidogrel for 12 months)
A – Atorvastatin 80mg
A – Atenolol (or other beta-blocker – commonly bisoprolol) titrated to maximum tolerated dose
A – ACE inhibitor (commonly ramipril) titrated to maximum tolerated dose
How is angina defined?
Discomfort in the chest, arm or neck.
What can bring on angina?
Exertions, cold weather or emotion.
Exacerbated by anaemia.
Name four different types of angina.
Stable
Unstable
Decubitus - lying down
Variant/Prinzmetal’s - coronary artery spasm
Syndrome X - during exercise test, no coronary artery disease
What is Prinzmetal’s or variant angina?
Angina associated with ST elevation may be associated with coronary artery vasospasm. Can be hard to distinguish from an MI until changes resolve rapidly with GTN.
Should be treated with a CCB and long-acting nitrate.
What is the gold standard investigation for angina?
CT Coronary Angiography