CBL Case 2

Question 1

Who is most at risk of a silent MI?

Answer 1

Diabetic patients as will have little/no pain perceived due to diabetic neuropathy

Question 2

How does alcohol affect the heart?

Answer 2

It is toxic to the myocardium → leading to arrhythmias

Question 3

What medication can INCREASE the risk of arrhythmias?

Answer 3

CETALOPRAM → for depression/anxiety (INCREASES risk of arrhythmias

Question 4

What would you prescribe someone following an MI?

Answer 4

1. ASPIRIN
2. ANTIPLATELET → e.g. Ticagrelor

Question 5

Following an MI why are patients more at risk of arrhythmias?

Answer 5

As damage to the electrical conduction of the heart → Re-entry mechanism

Question 6

Where do the coronary arteries come from and where do they drain into?

Answer 6

Come from

• Coronary sinus of Valsava

Drain into

• Coronary sinus (vein) which then drains into the right atrium

Question 7

When would you not use a DOAC (anticoagulant)?

Answer 7

If someone has metal in their body

Question 8

How can you assess the risk of someone developing a stroke?

Answer 8

CHA2DS2-VASc

Congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke or transient ischemic attack (TIA), vascular disease, age 65 to 74 years, sex category

Question 9

Where is the most common site for AF to occur?

Answer 9

In the pulmonary veins → decreases CO as atria & ventricles are NOT working together so ventricles do not fill correctly → INCREASE risk of clotting

Question 10

Do anticoagulants prevent stroke risk?

Answer 10

FALSE

Question 11

What is rheumatoid fever?

Answer 11

• Rheumatic fever is a very rare complication that can develop after a bacterial throat infection. It can cause painful joints and heart problems. Most people make a full recovery, but it can come back.
• Immune system starts attacking own healthy tissue instead