Cardiovascular - Acute Conditions

Question 1

what increases risk of an MI?

Answer 1

age
male
smoking 
HT
obese
hyperlipidaemia
DM
FHx <55yrs in 1st degree relative

Question 2

features of an MI?

Answer 2

crushing chest pain
radiating down left arm
nausea
sweating 
palpitations
fever

Question 3

how does an MI result?

Answer 3

atherosclerosis
plaques form
rupture
thrombosis occurs

Question 4

Ix for an MI?

Answer 4

ECG
coronary angiogram
troponin
CK
FBC, U+Es, glucose, lipids

Question 5

which is good for you, HDL or LDL?

Answer 5

HDL

Question 6

what chest leads are affected in an inferior MI?

Answer 6

II
III
aVF

Question 7

what chest leads are affected in a lateral MI?

Answer 7

I
aVL
V5
V6

Question 8

what chest leads are affected in an anterior MI?

Answer 8

V1, 2, 3 and 4

Question 9

what chest leads are affected in a posterior MI?

Answer 9

ST depression in V1, 2 and 3

Question 10

what changes occur in an NSTEMI on ECG?

Answer 10

ST depression

T wave inversion

Question 11

what arteries are blocked in an
inferior
lateral
anterior MI?

Answer 11

inferior - RCA
lateral - circumflex
anterior - LAD

Question 12

acute MI treatment?

Answer 12

MONA
morphine + anti emetic
oxygen 
nitrates
aspirin 300mg and clopidogrel 300mg

Question 13

what is the criteria for PCI?

alternative?

Answer 13

STEMI within 120mins

fibrinolysis if ≤12hrs but too late for PCI

Question 14

medical management post MI?

Answer 14

ACE
Bblocker
statin
aspirin + clopidogrel

Question 15

what anti platelet should be given if there is stroke Hx?

Answer 15

clopidogrel
OR
aspirin + dipyridamole

Question 16

post MI complications?

Answer 16

death
arrythmias
LVF
pericarditis
Dressler's syndrome

Question 17

when does dressler’s syndrome present?

Answer 17

2-5wks post MI

Question 18

what happens in an aortic dissection?

Answer 18

separation in the aortic wall intima leading to a false channel

Question 19

layers of the artery wall (out to in)?

Answer 19

tunica externa
media
intima

Question 20

features of an aortic dissection?

Answer 20

acute chest pain
radiates to back
pulse deficit 
BP difference in arms
hypotension

Question 21

Ix for aortic dissection?

Answer 21

ECG
CT scan
FBC, U+Es, LFTs, lactate, troponin, CK

Question 22

Tx for aortic dissection?

Answer 22

haemodynamic support
Bblockers
surgery (endovascular stent graft repair)

Question 23

what occurs in pericardial tamponade?

Answer 23

pericardiac fluid accumulates

reduces CO

Question 24

features of pericardial tamponade?

Answer 24

tachycardia
hypotension
elevated JVP
muffled heart sounds

Question 25

Ix and Tx of pericardial tamponade?

Answer 25

Echo

pericardiocentesis

Question 26

what is aortic coarctation?

Answer 26

narrowing of the aortic arch

Question 27

where does aortic coarctation usually occur?

Answer 27

site of ductus arteriosus, communication between aorta and pulmonary arteries

Question 28

how does aortic coarctation present?

Answer 28

early life
diminished lower pulses
upper extremity HT

Question 29

what murmur is heard in aortic coarctation?

Answer 29

ejection systolic

after S1

Question 30

what does ductus arteriosus normally do?

Answer 30

allows blood from RV (deoxy) to bypass fluid filled lungs and go into aorta

Question 31

investigation and treatment for aortic coarctation?

Answer 31

echo

surgery