Cardiology p 71-80 Flashcards
Risk factors for Acute coronory syndrome
HTN, DM, Smoking
what is s4 gallop
sound of atrial systole as blood is ejected from atria into ventricle and is associated with Acute coronory syndrome
what is kussmaul sign and what is it associated with..
Increase in JVP on inhalation is kussmaul sign
it is associated with constrictive pericarditis or restrictive cardiomyopathy
Displaced PMI (point of maximal impulse) is seen in
Left ventricular Hypertrophy and Dilated Caridiomyopathy
what is Dressler Syndrome
Pericarditis as a complication after 3 weeks of MI
continuous machinery murmur is seen in
Patent Ductus Arteriosus
Leads involved in anterior and inferior wall MI
which has the worst prognosis
anterior=ST elevation in leads v2-v4
inferior=ST elevation in leads II, III and avf
anterior wall MI will have the worst prognosis
leads involved in posterior wall MI
ST depression in leads v1 and v2
tx of premature ventricular contraction and atrial premature complex
none if mg+ and k+ levels are normal….tx wil worsen the outcome
what lowers mortality with acute coronory syndrome
Aspirin, Angioplasty and beta blockers
indication of clopidogrel
1- intolerance to aspirin
2- pt had angioplasty with stenting
Dx test of Acute coronory syndrome
EKG
Myoglobin
CK-MB
Troponin
which enzyme is best used to diagnose Reinfarction
CK-MB and also EKG to check for new ST- elevation
most common cause of death from MI
V tach comes first and then Ventricular fibrillation treated with electrical cardioversion or defibrillation
alternative to clopidogrel
prasugrel, ticagrelor
superiority of angioplasty over thrombolytics
survival and mortality benefit
fewer hemorrhagic complications
fewer complications of Myocardial Infarction
Complications of MI
RV failure
papillary muscle rupture
interventricular septum rupture
free wall rupture of left ventricle
Angioplasty(PCI) is to be performed when
within 90 minutes of arrival of pt.
complications of PCI
rupture of coronory arteries on balloon inflation
restenosis/thrombosis of the vessel after angioplasty
hematoma at site of entery into the arter(femoral artery hematoma)
what decreases the rate of restenosis
drug eluting stents by local T-cell response
what are absolute contraindications to thrombolytics
major bleeding into the bowel (melena) or brain
recent surgery in the last 2 weeks
severe HTN above 180/110
non hemorrhagic stroke within the last 6months
thrombolytics in STEMI is to be given when
within 30mins of the patients arrival
ACEin/ARB given with what EF
Ejection fraction <40%
at what level of LDL, statins is given
LDL > 100mg/dl
ST segment depression tx
Aspirin Heparin(LMWH) (prevents clot formation) GPIIb/IIIa inhibitors (reduces mortality in ST depression MI) nitrates beta blockers
names of GP IIb/IIIa inhibitors
Abciximab
Tirofiban
Eptifibitide
what condition GP IIb/IIIa inhibitors given in ST elevation ACS
pts who are to undergo angioplasty and stenting
tx of STEMI
Aspirin, PCI, thrombolytics, nitrates, beta blockers
tx of stable angina
aspirin, beta blockers, nitrates
If non ST elevation MI is not better with medicines then we do..
Angiography followed by Angioplasty
what do you mean not better with medical treatment of NSTEMI
not better means persistent pain, s3 gallop, CHF, worsening EKG, rising troponin
