Cardiovascular Flashcards
what are the se of acei
cough, angioedema, high potassium, first dose hypotension
monitoring of acei
u&e on intitialtion - can have an increase 30% of creatinine and 5.5 mmol potassium . significant impariemnt may occur in those with undiagnosies bl renal artery stenosis
moa for acei
inhibit conversion of angiotensin 1 to angiotensin 11
contraindiction of aci
pregnancy. Aortis stenosis may cause hypotension, renovascular disease
stage one htn
clinic >140/90. home >135/85
stage two htn
clinic >160/100 home >150/95
stage three htn
clinic >180/110
target bp <80
140/90
target bp >80
150/90
choice of anti-htn in diabetes
acei/arb (arb in african)
african/>55
ccb/ if HF - T-L diuretic
<55
acei/arb
what type of drug is indapamide
thiazide like diuretic
what is cCoarctation of the aorta
a congenital narrowing of the descending aorta.
what are the associations with cCoarctation of the aorta
Turner’s syndrome
bicuspid aortic valve
berry aneurysms
neurofibromatosis
findings for coarctation of the aorta
infancy: heart failure
adult: hypertension
radio-femoral delay
mid systolic murmur, maximal over the back
apical click from the aortic valve
CHA2DS2VASc
CHF, HTN, AGE 75/65-74,DM, STROKE/TIA/EMBOLUS,VASCULAR,SEX- female
NYHA
Heart failure severity scale
Wells score
Helps estimate the risk of a patient having a deep vein thrombosis
DVLA- hypertension
if Group 2 Entitlement the disqualifies from driving if resting BP consistently 180 mmHg systolic or more and/or 100 mm Hg diastolic or more
DVLA-angioplasty (elective)
1 WEEK OFF
DVLA-CABG
4 WKS OFF
DVLA- acute coronary syndrome & IF THEY HAVE ANGIOPLASTY
4 WEEKS OFF or if successful then 1 week
DVLA- ANGINA
driving must cease if symptoms occur at rest/at the wheel
DVLA- PACEMAKER
1 week off driving
DVLA ICD
if implanted for sustained ventricular arrhythmia: cease driving for 6 months
if implanted prophylactically then cease driving for 1 month. Having an ICD results in a permanent bar for Group 2 drivers
DVLA aortic aneurysm of 6cm or more
notify DVLA. Licensing will be permitted subject to annual review.
DVLA aortic aneurysm of 6.5cm or more
disqualifies patients from driving
heart transplant DVLA
do not drive for 6 weeks, no need to notify DVLA
catheter ablation for an arrhythmia dvla
2 days if successful
sex after mi
sexual activity may resume 4 weeks after an uncomplicated MI.
pde5 in after mi
PDE5 inhibitors (e.g, sildenafil) may be used 6 months after a MI.
exercise post mi
advise 20-30 mins a day until patients are ‘slightly breathless’
post acute coronary syndrome (medically managed)
add ticagrelor to aspirin, stop ticagrelor after 12 months
b-blocker se
bronchospasm
cold peripheries
fatigue
sleep disturbances, including nightmares
erectile dysfunction
bblocker ci
uncontrolled heart failure
asthma
sick sinus syndrome
concurrent verapamil use: may precipitate severe bradycardia
