Chest pain Flashcards

1
Q

Inferior MI leads + artery, Lateral MI leads + artery

A

Inferior MI leads + artery:
II, III, aVF
Right coronary artery

Lateral MI leads + artery:
I, aVL, V5, V6
Left Circumflex Artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CI to thrombolysis in MI

A

Active Bleeding
Aortic Dissection
Ischemic Stroke (last 3 months)
Closed Head or Facial Trauma (last 3 months)
Past Intracranial Hemorrhages
Structural Cerebral Vascular Lesions
Malignant Intracranial Neoplasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of pericarditis

A

Idiopathic
Infectious (viral, bacterial)
Inflammation (RA, SLE, scleroderma)
Metabolic (renal failure, hypothyroidism, hypercholesterolemia)
CV (MI, post infarction (Dressler’s), aortic dissection)
Misc (neoplasm, drugs, radiation, trauma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Signs + sx of pericarditis

A

Sudden onset palpitations, retrosternal pain, pleuritic
Low grade fever, night sweats, wt loss
SOB, tachypnea, non-productive cough

Signs:
Ewart’s sign (dullness + bronchial breath sounds between tips of scapula and spine)
Pericardial friction rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Ix + results for pericarditis

A

ECG: PR depression, ST elevation
CXR: normal to water bottle shape heart
Echo: effusion
Labs: CBC, INR, lutes, urea, Cr, ESR, CRP, trop, LDH, AST
Consider CT/ MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Rx for pericarditis

A

ASA 650mg Q4H or or ibuprofen 400mg Q6H x 2 weeks
PPI
Corticosteroids or colchicine for recurrent/ refractory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Signs of tamponade

A

Hypotension
Tachycardia
Elevated JVP
Pulsus paradoxicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Causes of CP

A

CVS: pericarditis, dissection, valve disease, tamponade, HF, ACS
Resp: PE, PNA, pneumothorax, malignancy, pleuritis
GI: GERD, esophageal spasm, hiatal hernia, PUD, biliary colic
MSK: costochondritis, HSV infection (shingles), rib fracture, fibromyalgia
Psych: anxiety. panic, delusion, somatoform

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sx of esophageal spasm

A

Globus
Dysphagia
GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ix for esophageal spasm

A

Barium swallow - tertiary waves
Esophageal manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rx for esophageal spasm

A

Diltiazem
Imipramine
Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MSK causes of CP

A

costochondritis, HSV infection (shingles), rib fracture, fibromyalgiA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tool to work out disposition in MI

A

HEART score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

6-8 wks post MI, recurrent CP DDx + Ix to order

A

ACS, Dressler’s syndrome, anxiety, PNA, PE. Ix = CRP, echo, CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Rx for Dressler’s syndrome

A

ASA, NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How to diagnose herpes zoster?

A

Viral swab

17
Q

Absolute CI to fibrinolytics in STEMI

A

prior intracranial hemorrhage, known cerebral vascular lesion, known malignant intracranial neoplasm, suspected aortic dissection, active bleeding, facial trauma within 3mo, ischemic stroke within 3 mo, severe uncontrolled hypertension

18
Q

Relative CI to fibrinolytics in STEMI

A

hx of chronic poorly controlled HTN, traumatic/ prolonged CPR, systolic BP >180