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CARDIO!!!! > Cardiology > Flashcards

Cardiology Flashcards

1
Q

What is ACS

A

Acute presentation of ischaemic heart disease

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2
Q

3 things making up ACS

A

STEMI
USTEMI
Unstable angina

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3
Q

Symptoms of ACS?

A

Chest pain - central and left sided, radiating to the jaw/ left arm, heavy and constricting

Certain patients e.g. diabetics and elderly may not experience any chest pain

Dyspnoea, sweating , nausea and vomiting

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4
Q

Physical signs of ACS

A

Patients presenting with ACS often have very few physical signs to ellicit, possibly tachycardic

if complications of the ACS have developed e.g. cardiac failure then clearly there may a number of findings
the patient may appear pale and clammy

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5
Q

Investigations for ACS

A

ECG
Cardiac markers e.g. troponin

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6
Q

Coronary artery - left anterior descending ECG changes

A

ANTERIOR
V1-V4

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7
Q

Coronary artery- right coronary ECG changes

A

INFERIOR
II,III, aVF

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8
Q

Coronary artery- left circumflex- ECG changes

A

LATERAL
I, V5-V6

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9
Q

Management of ACS

A

MONA
- Morphine. oxygen. nitrates. aspirin 300mg

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10
Q

When should you give oxygen in ACS

A

Only if sats are <94%

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11
Q

STEMI management

A

Dual anti platelet therapy
PCI

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12
Q

NSTEMI management

A

Aspirin 300mg
Fondaparinux if no immediate PCI planned
Estimate 6 month mortality using GRACE

If low risk - tricagrelor
If high risk - PCI + relevant drugs

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13
Q

Dual anti platelet - what to give?

A

Aspirin +
Tricagrelor if not at a high bleeding risk
Clopidogrel if high bleeding risk

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14
Q

GRACE

A

Age, HR+BP, cardiac arrest on presentation, ECG findings, troponin levels, cardio and Renal class

ACS stratifying

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15
Q

ACS secondary prevention

A

Aspirin, py12, beta blocker, ACE inhibitor, statin

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16
Q

Drugs with a PCI

A

Praugrel
Unfractioned heparin
Bailout glycoprotein IIb/IIIa inhibitor GPI
Drug eluding stents

17
Q

Killip class - post MI dangers

A

I - no heart failure signs
II- lung crackles
III- pulmonary oedema
IV- cardiogenic shock

18
Q

What is an aortic dissection

A

Tear in the tunica intima of the aortic wall

19
Q

Associations of aortic dissection

A

Hypertension, trauma, bicuspid aortic valve
marfans,collagens: Marfan’s syndrome, Ehlers-Danlos syndrome, Turner’s and Noonan’s syndrome, pregnancy, syphilis

20
Q

Features of an aortic dissection

A

Chest/back pain - severe/sharp/ tearing
Maximal on onset

Pulse deficit
Variation in systolic BP between the arms
Aortic regurgitation
Hypertension
No ECG changes

21
Q

What type of pain is more common in type A vs type B aortic dissection

A

Chest pain more common in type A
Upper back pain more common in type. B

22
Q

Spinal artery dissection effect

A

Paraplegia! Aortic dissection can present neurologically

23
Q

Distal aorta dissection effect

A

Limb ischaemia

24
Q

Stanford classification of aortic dissection: type A and type B

A

Type A: ascending aorta
Type B: descending aorta, distal to left subclavian origin

25
Q

Debakey classification of aortic dissection: Type I, II and III

A

Type I- originates in asce
nding aorta, propagates to at least the aortic arch

Type II - originates in and confined to the ascending aorta

Type III- originates in descending aorta, rarely extends proximally

26
Q

investigations of aortic dissection

A

CT angiography - false lumen
Chest XRAY- widened mediastinum
TOE- for patients where CT is too risky

27
Q

Management of aortic dissection - type A vs type B

A

type A - surgical, BP medication while waiting

type B- conservative, bed rest, reduce BP with IV labetalol

28
Q

Complications of aortic dissection

A

Backward- aortic incompetence. regurgitation. MI

Type B - Unequal arm pulses, BP, stroke, renal failure

29
Q

What is a cardiac tamponade

A

Accumulation of pericardial fluid under pressure

30
Q

What is becks triad

A

Used for cardiac tamponade
Hypotension, raised JVP, muffled heart sounds

31
Q

Signs of cardiac tamponade

A

Becks triad
Dyspnoea, tachycardia
Pulsus paradoxus
Kassumuls sign
Electrical altens

32
Q

What is pulses paradoxes

A

Abnormally large BP drop on inspiration JVP reduces

33
Q

What is electrical altens

A

Alternating QRS complex. Swinging heart

CARDIO!!!! (2 decks)

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