Cardiology Flashcards
CAD Risk factor
( Family History )
Very important two points
- First degree Family History ( Mother , Father , siblings )
- They Presented in young age Men.55 / Women.65.
Cardiac Chest pain Features
Dull Pressure like Squeezing Burning Tight Heaviness Aching
Cardiac Chest Pain Is not
NOT Tender NOT Positional ( means not changing with positions) NOT Pleuritic NOT Sharp NOT knife like or pinpoint like NOT lasting Few seconds
ACS duration of the chest pain is
10-30 Minutes
Fever + Chest pain
Pneumonia
PE ( clotting factors gives fever )
Unequal BP in both arms
Aortic dissection Diagnosed with CXR which showed widened mediastinum
Confirmed TEE
First Diagnostic test for Cardiac chest pain
EKG
When To do Cardiac enzymes
ACUTE PAIN ONLY
Not clinic - if he is in the clinic send him to the ER
Not chronic
Exercise tolerance test ( ETT ) Indication
When the EKG is not diagnostic comes normal and the patient still have chest pain
Two Things think about them
- The patient can exercise ( No fracture )
- You can read the EKG in the Tolerance test “ Like no pathologies that prevent you from reading it Like Digoxin use , Pacemaker , Left bundle branch block .. etc
Maximum heart rate
220-Age
Chronic Chest pain - Do Exercise tolerance test EKG
You Cannot read EKG ?
- Nuclear Isotope scan ( Thallium or Sestamibi ).
2. Do Echo for wall motion abnormalities.
Chronic Chest pain - Do Excersice tolerance test EKG
Cannot Exercise??
- Persantine ( Diperidamole ) or adenosine with Isotope scan
- Dobutamine with Echo
When You can’t Use Dipyridamole ?
Asthmatic
caffeine
Dobutamine with Echo contraindications :
- severe HTN
- LV outflow obstruction
- Ventricular arrhythmia
+ HOLD B-Blockers before the test
ST deprresion on EGK means
Ischemia NOT Infarction
TX
- ST - Elevation
- ST - Depression
- Aspirin + Antiplatelets + Angioplasty
2. Aspirin + Antiplatelets + LMWH
Holter Monitor For
Rhythm Problems NOT ISCHEMIA
Can be for 1 day - 3 days Max
Surgically corrected stenosis after Angiography
If the stenosis 70% and Above