Cardiology Flashcards
The single worst risk factor for CAD is
diabetes
The mechanism of S3 gallop is
rapid ventricular filling during diastole
S4 gallop is the sound of
atrial systole into a tiff or noncompliant left ventricle
The best initial diagnostic test for ischemic-type pain is
EKG
CK-MB stays elevated 1-2 __
days
Troponin stays elevated 1-2 ___
weeks
Myoglobin elevates as early as 1-4 ____ after the start of chest pain
hours
Which cardiac enzyme rises first in acute chest pain?
Myoglobin
Stress testing is only the answer if the case is ____ and the EKG/other dx tests are inconclusive
NON-ACUTE
Only choose angiography if
the stress test is normal
If patients cannot exercise to a target HR >85% of max, then the answer is
dipyridamole or adenosine thallium stress test or dobutamine echo
EKG will be unreadable for ischemia in which situations?
Left BBB, digoxin, pacemaker, LVH, any baseline ST segment abnormality
Obese patients might need ____ testing for ischemia
sestamibi nuclear stress
To the myocardium, thallium looks like ___
potassium! Na/K ATPase will recognize it! SCIENCE IS COOL
Stress testing should never be performed in a patient with
current chest pain
The most specific method to dx a new infarction 5 days after an MI is
CK-MB
*it will have returned to normal 2-3 days after that first one
The best initial therapy for ACS patients is
aspirin
___ or ___ are added to aspirin in patients with acute MI
Clopidogrel or ticagrelor
P2Y12 antagonists such as clopidogrel work by
blocking platelet aggregation (inhibiting ADP-induced activation of the P2Y12 receptor)
Which therapies lower mortality in STEMI?
thrombolytics and primary angioplasty (time-dependent)
Percutaneous coronary intervention MUST be performed within ___ minutes of arrival at the ED for STEMI
90 minutes
What has the single greatest efficacy in lowering mortality in STEMI?
Urgent angioplasty
Angioplasty is the answer if the question includes a contraindication to
thrombolytics
___ are indicated when the patient has chest pain for <12 hours and has ST elevation in 2+ leads
Thrombolytics