cardiology p 64 - 70 Flashcards
most accurate method of detecting coronary artery disease?
angiography
what kinds of rhythm disorder Holter can detect?
a fib, flutter, ectopy such as premature beats, or ventricular tachycardia
what are the 3 meds that lower mortality for pts with chronic angina
aspirin, beta blockers, nitroglycerin
a pt with acute coronary syndrome arrives at ER, what are the drugs you must give right away
2 antiplatelet meds
aspirin, and any one of the below med
clopidogrel, prasugrel, ticagrelor
what is the mech of clopidogrel, prasugrel, or ticagrelor?
P2Y12 receptor inhibitor
true or false
the use of 2 antiplatelet meds also apply to chronic/stable coronary artery disease
false
what meds have the best mortality benefit in chronic angina
aspirin and beta blocker
what are the 3 indications for clopidogrel?
- combination with aspirin on all acute coronary syndrome
- aspirin intolerance such as allergy
- recent angioplasty with stenting
what is the indication for Prasugrel?
angioplasty and stenting
what is the additional therapy for angina refractory or persistent through other treatment
ranolazine
what are the two cardiac issues that can benefit the best from ACE inhibitors/Angiotensin receptor blockers
- low ejection fraction/systolic dysfunction
2. regurgitant valvular dz
what is the name of the drug that is an alternative to prasugrel or clopidogrel that is added to aspirin?
ticagrelor
with CAD, what is the goal of LDL?
less than 100 mg/dl
what are the 3 indications for calcium channel blockers?
- severe asthma preventing the beta blocker usage
- prinzmetal variant angina
- cocaine-induced chest pain
a pt who used cocaine came to ER for chest pain, would you give beta blocker?
no, it’s contraindicated.
name 3 side effects of calcium channel blockers
edema, constipation (verapamil especially), heart block
3 indications for coronary artery bypass grafting?
- 3 vessels with at least 70% stenosis in each vessel
- Lt. main coronary artery occlusion
- two vessel dz in a pt with diabetes
percutaneous coronary intervention (PCI) is also called
angioplasty
what is the best therapy for acute coronary syndrome especially with ST segment elevation?
percutaneous coronary intervention
does PCI provide mortality benefit for stable pts?
No
Side effects of Niacin?
Elevation in glucose and uric acid, pruritus
A pt comes in with LDL of 120 and you decide to give statin, what lab must you do before you give statin?
AST, ALT
What particular lipid lowering agent increases the risk of myositis?
Fibric acid derivatives
True or false?
Calcium channel blockers lower mortality
False, actually they increase mortality why? Bc of reflex tachy à inc heart rate
What is the effect of calcium channel blockers in terms of myocardial oxygen consumption?
Decreases, since it is a negative ionotrope
So if calcium channel blockers reduce myocardial oxygen consumption as a negative ionotrope, why isn’t it beneficial for CAD?
B/c of the inc heart rate, overall increases myocardial oxygen consumption
