cardiovascular disease 2

Question 1

3 ways to tell if someone has coronary artery disease

Answer 1

exercise ECG
myocardial perfusion scan
angiography

Question 2

treatment of coronary artery disease

Answer 2

lifestyle modification
cholesterol lowering
antiplatelet (usually aspirin)

Question 3

medications which can reduce anginal attacks

Answer 3

nitrates
calcium channel blockers
nicrodil (potassium opening tablet)

Question 4

what can be used to reduce anginal attacks if medication not workingn

Answer 4

stenting

coronary artery bypass grafting

Question 5

how to tell if it its a myocardial infarction

Answer 5

ECG (elevation of ST)

serum troponin measurement

Question 6

what is the actual trigger for MI

Answer 6

the clot

plaque has been there many years

Question 7

when to stent NSTEMI and STEMI

Answer 7

STEMI immediately

NSTEMI within 72 hours

Question 8

how to treat STEMI/NSTEMI

Answer 8

dual anti-lately therapy 
anticolagulatonfor 24-72 hours
avoid O2
then secondary prevention
DAPT for a year,

Question 9

what can be used to detect ventricular impariment

Answer 9

transthoracic echocardiography

Question 10

treatment of heart failure

Answer 10

ACE inhibitors e.g. rampril

betablockers

Question 11

how to diagnose valve disease

Answer 11

transthoracic echocardiography

Question 12

treatment of valve disease

Answer 12

symptomatic
- valve surgery
either metallic or biologic

Question 13

what do metallic bridges requrie

Answer 13

Anticogaluation medication
warfarin
- may be stopped if bridged with heparin

Question 14

investigation of arrhrymias

Answer 14

diagnosis made by ECG at time of symptoms

Question 15

what is a heart block

Answer 15

interruption of signal between atria and ventricles

Question 16

atrial fibrillation and flutter treatemtn

Answer 16

anticoagluate if high stroke risk (score by Chads2 VaSc)

slow rate with beta blockers or calcium

Question 17

treatmet of supra ventricular tachycardia

Answer 17

can use drugs or electric shock to put into normal rhythm

frequent attacks - beta blockers

Question 18

ventricular tachycardia or fibrillation treatment

Answer 18

immediate cardio version (shock)

anti -arrythmic drugs

Question 19

treatment of brachyarrhythma

Answer 19

pace maker
Types
- dual chamber (nothing for tachycardia)
implantable cardiverter/defibrillator
cardiac resynchronisation therapy

Question 20

when to defer treatment for MI

Answer 20

3-6 months post MI

as they will be on dual antiplatlet therapy