Cardiology Flashcards
When is angioplasty needed for acute treatment in myocardio infarction? What blood thinner is given?
No clopidogrel needed, ASA is given. Single vessel disease.
What are the first treatment in myocardial infarction?
Aspirin and nitrates
What procedures are done for patients who have single vessel disease? Describe its clopidogrel use?
Angioplastic, bare metal stent, drug eluding stent. No clopidogrel needed, clopidogrel for 1 month, for one year
How much time do you have for door to balloon?
90 minutes
What drug is equivalent to clopidogrel?
Prasugrel
When is TPA given to patient with my cardio infarction?
No PCI is available within 90 minutes transport time
When is CABG done?
Multivessel disease or left main stem equivalent
For patients with coronary artery disease what drug is given to lower the heart rate? What should the heart rate be?
Beta blocker, less than 70
What are the credit treatments for coronary artery disease?
Beta blocker, ASA, Clopidogrel, ACEi, Statins
What are the three types of imaging for stress testing? What are the two types of stress testing?
EKG, Echo, Nuclear; Exercise, Pharm
What can be use for pharmaceutical stress testing?
Dobutamine or adenosine
What are the complication for MI? How are they diagnosed? What drug should not be given?
Right ventricle failure, right-sided ECG no nitrates should be given.
Aneurysm, diagnosed by Echo. Arrhythmia VTach/V fib ventricular tech copy from dying cells. Brady/blocks - AV nodal dysfunction
How do you patients with left sided heart failure present? Right sided?
Pulmonary edema, shortness of breath, crackles, dyspnea on exertion, Orthopnea, paroxysmal nocturnal dyspnea, S3; Abdominal pain, JVD, peripheral Edema
What are the three ways that systolic heart failure can occur?
Chronic damage, ischemic damage, valvular damage.
What are the three sources for diastolic heart failure?
Pericardium, restrictive, hypertrophic cardio myopathy.
What are the two types of pericardium diastolic heart failure?
Tampanode, constrictive pericarditis
Explain class III and 4 of CHF?
Comfortable at rest only, Dyspneic at rest
What is the test of choice for congestive heart failure diagnosis? Why?
2-D echo, ejection fraction, Valve lesions
What are the shortcomings for BNP?
Cannot discern between the left or right heart failure or diastolic or systolic heart.
What is is the treatment for congestive heart failure
Beta blocker, ACEi, salt restriction less than 2 g, fluid restriction 2 L; if ischemic ad aspirin and Statin
For patients with congestive heart failure and a ejection fraction of less than 35% what should be given?
AICD
Where is given Treatment for class one CHF patients? Class to? Class III? Class IV?
BBs, ACEI; Loop diuretics; BiDil (hydralazine/isosorbide dinitrate), Spirolactone; Pressors
How should diastolic congestive heart failure be treated? Systolic?
Beta blockers; NYHA stage
How is congestive heart failure diagnosed?
BNP then echo. Left Ventriculogram is the best test
