Cardiovascular Management Flashcards
1
Q
ACS
A
- MONA
- Dual anti-platelet (aspirin, clopidogrel)
- Fondaparinux
- Secondary prevention: ACEi, B blockers, statins
- PCI (fibrinolysis within 12h if PCI not possible within 2h)
2
Q
DVT/PE
A
DOACs or warfarin (need LMWH to cover until INR sufficient for warfarin or for a few days for dabigatran/edoxaban [but not apixiban/rivoroxaban])
3
Q
Type B Aortic Dissection
A
- control HTN with β blockers/Ca channel blockers (e.g. amlodipine)
- avoid surgery as risk of retrograde dissection
- surgery indications: rupture, renal/visceral/limb ischaemia, refractory pain, uncontrolled HTN
4
Q
HTN: <55 or with type II diabetes
A
- ACEi then add drugs
5
Q
HTN: >55 or afro-Carribean descent
A
- Ca channel blockers then add drugs
6
Q
Angina
A
- exacerbating factors: anaemia, fast AF, thyrotoxicosis
- RFs address: aspirin, statins, HTN control (ACEI), stop smoking, control diabetes
- PRN GTN
- anti-anginal first line = Ca channel blocker, β blocker
7
Q
SVTs (narrow complex tachycardias)
A
- Vagal manoeuvres (Valsalva, carotid massage)
- adenosine
8
Q
Ventricular Tachycardia
A
- amiodarone (K+ blocker = rhythm control)
- DC cardioversion
9
Q
Chronic AF anti-coagulation
A
CHADVASC and HASBLED to manage the risks of bleeding/clotting
10
Q
Acute AF anti-coagulation
A
- immediate anti-coagulation pre RFs for emboli detected: heparin (within 48h ideally)
- if not within 48h then make sure 3 weeks anticoagulation pre cardioversion
- severe –> DOAC/warfarin
11
Q
First line heart failure
A
β blockers and Ca channel blockers (e.g. amlodipine)
12
Q
AF rate vs rhythm control
A
- RATE: β blocker/rate limiting Ca channel blocker (verapamil, not amlodipine)
- digoxin second line
- asthma is contraindication for non-specific β blocker
- RHYTHM: flecinaide for cardioversion, or amiodarone if evidence of structural heart disease
- DC cardioversion if hypotensive and tachyarrythmia
13
Q
Acute pulmonary oedema
A
loop diuretic
14
Q
Ca channel blockers/beta blockers
A
- type B aortic dissection
- first line HF
- rate control AF: specifically verapamil
- angina
15
Q
Second line rate control AF
A
= digoxin
