Cardiology - Chest Pain Flashcards
chest pain presentations
acute chest discomfort
shortness of breath
cardiac arrest - fleeting pain
acute chest pain with ST elevation on ECG (STEMI) the patient should be treated to open with the artery in the cath lab within
a.30 mins
b.60 mins
c.90 mins
d.6 hours
c.90 mins
unstable angina
myocardial ischaemia but no damage to cells / muscles not as acute presentation
definition of MI
increased troponin and 1 of…
ECG change
Symptoms
Pathological Q waves
Echo evidence
thrombus
which vessel supplies the septum of the heart
a.left anterior descending
b.left circumflex
c.right coronary
d. left main circumflex
e.braciocephalic
a.left anterior descending
when do the coronary aa fill
a.asystole
b.systole
c.diastole
c.diastole
assessment for MI
assess patient
ECG and troponin
what should be done if patient is having a STEMI
a.give aspirin
b.refer to cath lab
c.give pain relief
d.resus and observe
b.refer to cath lab
stress induced narrowing of the coronary aa occurs in which condition
a.tachyarrhythmia
b.tako tsubo cardiomypathy
c.critical illness eg sepsis
d.pulmonary embolism
b.tako tsubo cardiomypathy
what needs to be taken into account when deciding if anti thrombotics could be given
patient characteristics
presentation - chronic vs acute
comorbities - CKD,HF diabetes
co med - oral anticoagulant
what is the treatment for dissection of the aorta
SURGERY
but first
pain relief, beta blocker and GTN
then theatre
suspected dissection of the aorta what should be done first
a.pain relief, beta blocker and GTN
b.surgery
a.pain relief, beta blocker and GTN
pericarditis is inflammation of the lining of the heart
a key symptom is chest pain worsened by taking a deep breath and a friction rub on auscultation
what is the 4 investigations that should be done for this
ECG
echo
CXR
CRP/Troponin
patient with pericarditis what is the first line management after being admitted to hospital
a. aspirin and NSAID
b.surgery
c.aspirin, NSAID colchisine and sports ban
d.colchisine, aspirin, NSAID and low dose steroids
a. aspirin and NSAID
then after 4-6 weeks in hosp
colchisine and sports ban
if the pericarditis returns
colchisine, aspirin and NSAID and low dose steroid
cardiac differentials for acute chest pain
myopericarditis - ECG and trop rise but normal vessels in cath lab
cardiomyopathies
tachyarrhytmias
aortic stenosis
