Cardiovascular - Acute Conditions Flashcards
what increases risk of an MI?
age male smoking HT obese hyperlipidaemia DM FHx <55yrs in 1st degree relative
features of an MI?
crushing chest pain radiating down left arm nausea sweating palpitations fever
how does an MI result?
atherosclerosis
plaques form
rupture
thrombosis occurs
Ix for an MI?
ECG coronary angiogram troponin CK FBC, U+Es, glucose, lipids
which is good for you, HDL or LDL?
HDL
what chest leads are affected in an inferior MI?
II
III
aVF
what chest leads are affected in a lateral MI?
I
aVL
V5
V6
what chest leads are affected in an anterior MI?
V1, 2, 3 and 4
what chest leads are affected in a posterior MI?
ST depression in V1, 2 and 3
what changes occur in an NSTEMI on ECG?
ST depression
T wave inversion
what arteries are blocked in an
inferior
lateral
anterior MI?
inferior - RCA
lateral - circumflex
anterior - LAD
acute MI treatment?
MONA morphine + anti emetic oxygen nitrates aspirin 300mg and clopidogrel 300mg
what is the criteria for PCI?
alternative?
STEMI within 120mins
fibrinolysis if ≤12hrs but too late for PCI
medical management post MI?
ACE
Bblocker
statin
aspirin + clopidogrel
what anti platelet should be given if there is stroke Hx?
clopidogrel
OR
aspirin + dipyridamole
post MI complications?
death arrythmias LVF pericarditis Dressler's syndrome
when does dressler’s syndrome present?
2-5wks post MI
what happens in an aortic dissection?
separation in the aortic wall intima leading to a false channel
layers of the artery wall (out to in)?
tunica externa
media
intima
features of an aortic dissection?
acute chest pain radiates to back pulse deficit BP difference in arms hypotension
Ix for aortic dissection?
ECG
CT scan
FBC, U+Es, LFTs, lactate, troponin, CK
Tx for aortic dissection?
haemodynamic support
Bblockers
surgery (endovascular stent graft repair)
what occurs in pericardial tamponade?
pericardiac fluid accumulates
reduces CO
features of pericardial tamponade?
tachycardia
hypotension
elevated JVP
muffled heart sounds
Ix and Tx of pericardial tamponade?
Echo
pericardiocentesis
what is aortic coarctation?
narrowing of the aortic arch
where does aortic coarctation usually occur?
site of ductus arteriosus, communication between aorta and pulmonary arteries
how does aortic coarctation present?
early life
diminished lower pulses
upper extremity HT
what murmur is heard in aortic coarctation?
ejection systolic
after S1
what does ductus arteriosus normally do?
allows blood from RV (deoxy) to bypass fluid filled lungs and go into aorta
investigation and treatment for aortic coarctation?
echo
surgery
