dif to remember Flashcards
Myocardial infraction complication - Interventricular septal rupture, papillary muscle rupture, ventricular pseudoaneurysm, ventricular free wall rupture - time
Interventricular septal rupture –> 3-5 d
papillary muscle rupture –> 3-4 d
ventricular pseudoaneurysm –> 3-14 d
ventricular free wall rupture –> 5-14 d
antiarrhytmics Class IC - clinical use
- SVT (including atrial fibrillation)
2. Only last resort in refractory VT
GPIIb/IIIa inhibitors - clinical use / pt
acute coronary sundromes (only unstable angina and non-stemi) in those who are to undergo angioplasty and stenting
they lead to reduction in mortality on those with ST depression, esp with high enzymes who then develop muocardial infraction requiring PCI with stenting
AR - valve replacement
- EF less than 55 or LVESD greater than 55
- Repairing the valve means tightening the ends of the valve with sutures
MR - valve replacement
When LVESD is above 40 mm or EF drops below 60%
–> surgical valve repair or replacement
MI criteria
- at least 1 mm segment elevation in at least 2 contiguous limb leads
- 2mmm elevation in 2 continguous precordial limbs
- New LBBB
Diastolic dysfunction - treatment
- the management here is not as clear as in the systolic
- b-blockers have clear benefits
- digoxin and spironolactone has no benefit and should not used
- diuretics to control symptoms
- unclear benefit for ACEi and ARBs and hydralazine
AR - physical findings (not the murmur)
- wide pulse pressure
- water-hammer (wide,dounding) pulse
- Quincke pulse (puslations in the nail)
- Hill sign (BP in legs as much as 50 above arm)
- head bobbing (de Musset sign)
HF with preserved EF - spironolactone
- not decreased mortality
- reduced hospitalisation rate
- indication in peripheral edema and lung congestion fnsaid
drug that is contraindicated in patients with dilated cardiomyopathy and why
NSAID
worsen afterload by inhibiting prostagladin synthesis and by counteracting the benefits of ACEi
large vessel vasculitis types (and epidemiology)
- Temporal (giant cels) arteritis (older female)
2. Takayasu arteritis (usually asian females under 40)
Medium-vessel arteritis types
- Polyarteritis nodosa
- Kawasaki disease
- Buerger disease (thrommboangiitis obliterans)
small vessel vasculitis types
- Granulomatosis with polyangiitis (Wegener)
- Microscopic polyangiitis
- Eosinophilic granulomatosis with polyangiitis (Chung strauss)
- Henoch-Schonlein purpura
Takayasu arteritis - sign and symptoms
- weak upper extremity pulses (pulseless disease)
- fever 3. night sweats 4. arthritis 5. myalgias
- skin nobules 7. ocular disturbances
Polyarteritis nodosa - symptoms
- fever 2. weight loss 3. malaise 4. headache
- GI (abdominal pain, MELENA) 6. hypertension
- neurologc dysfunction 8. cutaneous eruption
- renal damage
typically involves renal and visceral vessels
NOT PULMONARY ARTERIES