Cardiology long

Question 1

What kind of ECG changes for a NSTEMI infers worse prognosis?

Answer 1

ST depression is worse than T wave inversion of flattening

Question 2

Complications of myocardial infarcts

Answer 2

arrhythmias, cardiac failure, further angina, embolic events, surgical (MR, infarct related VSDs)

Question 3

Ischaemic heart disease risk factors

Answer 3

Previous ischaemic heart disease, DM, hypertension, family history, smoking, oral contraceptives or premature onset of menopause, obesity and physical inactivity, high serum homocysteine levels , lon

Question 4

Risk factors for ischaemic heart disease

Answer 4

• Modifiable
  
  • Lifestyle
    
    • Obesity and inactivity
  • Drugs
    
    • COX2/NSAIDs in high doses prolonged
    • Oral contraceptives
  • Smoking
• Non-modifiable
  
  • Medical history
    
    • Previous IHD
    • Diabetes
    • Early menopause
    • Hypertension
    • Hyperlipidaemia
    • Erectile dysfunction
  • Family history

Question 5

Cholesterol aims for patients with established coronary artery disease

Answer 5

Total cholesterol <4

LDL <1.8

Question 6

Investigations to ask about in a patient with ischaemic heart disease

Answer 6

ECHO

Exercise test

Cardiac cath

Question 7

Most common side effect of ticagrelor

Question 8

Investigations post IHD

Answer 8

• Left ventricular function - ECHO, left ventriculogram
• Complications - ECHO (valvular regurg, left ventricular thrombus, infarct-related VSF
• Further ischaemia - stress test, cardiac cath
• Viability - MRI, sestamibi scan

Question 9

What is the issue with using beta blockers in ESRF

Answer 9

Tend to accumulate and can cause hyperkalaemia