Cardiology Flashcards
What pharmocologic agents reduce mortality in patients with an NSTEMI?
Aspirin and Beta Beta blockers are the only drugs that reduce mortality and morbidity in NSTEMI patients.
What type of imaging study is appropriate for a patient with a pre-existing condition that makes the baseline EKG unintrepretable with exercise (i.e. bundle branch block)?
Perfusion imaging with persantine/regadenoson will illustrate the function of the myocardium using a radioactive tracer.
Contraindicated with COPD
use with caution with hx of seizures
A patient with Wolf- Parkinson White goes into atrial fibrilation.
What is the best initial step?
The best initial step for a patient with wolf-parkinson white who is in a-fib is
Carotid Massage or Valsalva
A patient with Wolf- Parkinson White goes into atrial fibrilation.
What is the pharmacological treatment?
Pharmacological treatment for apatient with Wolf- Parkinson White who goes into atrial fibrilation is
Procanimide or ibutilide
A patient with Wolf- Parkinson White goes into atrial fibrilation.
What medications are contraindicated in this patient?
Medications that are contraindicated in a patient with WPW in atrial fibrilation are
atrioventricular nodal blockers
eg. digoxin
What pharmacological therapy is initiated if the ASCVD risk is >10%
Begin statin therapy when the calculated ASCVD risk is >10
How high does your TG need to be to begin fimbrate therapy?
begin fimbrate therapy if TG levels are >500
What is the first line treatment for acute CHF exacerbation?
use Loop diuretics (“-mide) to decrease fluid overload in patients with acute CHF and chronic CHF
A cardiac murmur that increases with handgrip indicates that the murmur is on which side of the heart?
Left side.
What complications can lead to cardiac arrest within the first 24-48 hours after an MI?
Arrhythmias (v-tach, v-fib) are more likely to cause cardiac arrest within the first 48 hours after an MI
What are the indications for a coronary artery bipass graft evaluation?
Evaluation for CABG if the patient has severe blockage in 3 or more coronary vessels
What is the initial treatment for a stable patient with SVT?
the initial treatment for a stable patient with SVT is
vagal maneuvers
*vagal maneuvers: valsalva, carotid massage, cold stimulus to the face, coughing
What is the most significant risk factor for stroke?
The most significant risk factor for stroke is
HYPERTENSION
What is the drug of choice for long term treatment of prinzmetal angina?
Long term treatment of prinzmetal angina is with a Calcium Channel Blocker to prevent vasospasm.
Diltiazam
Amlodipine
nifedapine
*Prinzmetal angina = transient ST elevation, normal coronary arteries, chest pain is often worse in the morning or aggrevated by smoking
What is this rhythm?
This rhythm is a monomorphic ventricular tachycardia
look for wide QRS complexes and a ventricular rate above 100
treat a stable patient with amiodarone, procanimide, or lidocane
unstable patients should be cardioverted
What is this rhythm?
This rhythm is super ventricular tachycardia
look for a narrow QRS complex and a rhythm faster than what the max heart rate should be for the patient’s age
(220-patient age)
reentry is the most common cause of SVT
What do you see in this EKG?
What does it mean?
this EKG shows an ST depression in V1-V3
this indicates a posterior MI caused by an occlusion of the posterior descending coronary artery
