CV Disease II Flashcards
How to investigate coronary artery disease?
Angiogram >myocardial perfusion >ECG
Tx coronary artery disease?
Lifestyle
Statin - reduce cholesterol - HMG CoA reductase inhibitors
Anti-platlet - lower MI risk
If CAD = angina - nitrates
How to investigate MI?
ECG - look for elevations ST portion
Serum troponin - take 3-4 hours to elevate
Tx of MI?
Immediate dual anti-platelet therapy - aspirin and clopidogrel
Aspirin and opiates
Angiogram - see if stenting needed
DAPT for 1 year - followed aspirin and lifestyle
What would you expect to see elevated in serum levels with heart failure?
B-type natriuretic peptide
Tx heart failure
ACE inhib, beta blocker, aldosterone antagonist
How diagnose valvular disease?
Transthoracic echocardiogram
Transoesophgeal better
Tx of valvular disease?
Symptomatic - valve surgery
No drugs can fix - but can alleviate symptoms
How diagnose arrhythmias?
Diagnosis - at time of symptoms
Use: echocardiogram, coronary angiogram and family screening
What is pacemaker- contraindications?
Dual chamber - used for bradycardia
Not tachycardia or ventricular fibrillation
What can use for ventricular tachycardia cardia/ v fibrillation
Implantable defibrillators
Tx AF/ atrial flutter
Slow rate beta/Ca blockers
Anticoag for high stroke risk
Tx supraventircular tachycardia?
Vagal manoeuvres and IV adenosine
Tx ventricular tachycardia/ fibrillation
Immediate DC cardio version
Deferring tx?
Rarely need to refer
Recent MI - defer 3-6 month if poss
