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RM - Cardio Summary > Diseases > Flashcards

Diseases Flashcards

1
Q

Presentation of Angina

A

Central chest pain on exertion + autonomic features

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2
Q

4 rare causes of angina

A

Anaemia
Tachyarrhythmia
Vasculitis
HCM

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3
Q

Cause of Prinzmental angina

A

Coronary artery spasm

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4
Q

1st -> 4th line maintenance therapy for angina

A

1st - Beta-blocker!! or CCB
2nd - other
3rd - + isosorbide mononitrate
4th - + nicorandil or ivabradine (decreases HR)

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5
Q

2 add on therapies for all angina patients

A

GTN spray

Aspirin

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6
Q

3 diagnostic tools for ACS

A

Cardiac biomarkers
Symptoms of ischaemia
ECG changes

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7
Q

3 cardiac biomarkers used for ACS - peak times

A

Troponin - high within 30 mins peak = 24-48hrs, baseline = 5-14d - if not +ve in 6hrs - not MI

CK-MB - cardio specific - high within 45 mins, peak = 24hrs, base = 72hrs

Myoglobin - highly sensitive, not specific

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8
Q

4 key ECG changes in ACS - general

A

ST elevation
T wave inversion
Q waves
New onset BBB

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9
Q

3 ECG criteria for STEMI

A

=/> 1mm in 2 adjacent limb leads
=/> 2mm in 2 contiguous precordial leads
New onset bundle branch block

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10
Q

2 people get silent MI’s

A

Elderly

Diabetics

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11
Q

4 abnormal MI presentations

A

Syncope
Epigastric pain + vomiting
Stroke
Acute confusion

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12
Q

4 lateral ECG leads + artery affected

A

I, aVL, V5 and V6

Left circumflex

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13
Q

3 inferior ECG leads + artery affected

A

II, III, aVF

Right coronary artery

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14
Q

2 septal ECG leads + artery affected

A

V1, V2

Left anterior descending

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15
Q

4 anterior ECG leads + artery affected

A

V1, V2, V3, V4

Left anterior descending

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16
Q

3 signs of HF

A

3rd HS
Raised JVP
Basal crepitations

17
Q

9 DDx for MI

A 
Angina
Pericarditis
Myocarditis
Aortic dissection
PE
Reflux
Peptic ulcer
MSK
Anxiety
18
Q

Overview of STEMI management

A

MONA+T, PCI or fibrinolysis

19
Q

PCI or fibrinolysis guidelines

A

Both within 12 hrs of symptom onset
PCI within 120 mins of presentation
Fibrinolysis if not within 120 mins of presentation

20
Q

MONA+T

A 
Morphine + anti-emetic (metoclopramide or cyclizine)
Oxygen - target 94-98% (88-92%
Aspirin - 300mg immediately
Nitrates - if BP >90
Ticagerol 150mg with aspirin if STEMI
21
Q

6 fibrinolysis contraindications

A 
<3 weeks trauma/surgery/head injury
PHx intracranial haemorrhage
Intracranial malignancy
<6 wks stroke
Non-compressible punctures (liver biopsy, LP)
Bleeding disorders 
GI bleed
22
Q

1st line fibrinolysis

A

Tissue plasminogen activators (i.e. Alteplase)

23
Q

Discharge MI drugs

A

ACEi
Beta-Blocker - as soon as haemodynamically stable
Dual antiplatelet therapy - aspirin + ___
Statin

24
Q

3 NSTEMI management

A

Aspirin + anti-thrombin (IV eptifibatide or tirofiban) asap

PCI within 96 hrs

25
Q

Driving advice - ACS

A

Angioplasty - 1wk
MI - 4 wks (no DVLA)
MI + bus, coach, lorry - 6wks + DVLA

26
Q

Back to work after MI

A

2 months

27
Q

10 MI complications - List

A 
Cardiac arrest - VF
Cardiogenic shock
Tachyarrhythmia - VF/VT
Bradyarrhythmia - AV node block
Mitral regurgitation
LV aneurysm
Pericarditis
LV free wall rupture
Ventricular septal defect
Dressler's
28
Q

Post-MI cardiogenic shock management

A

Inotropes

Intra-aortic balloon

29
Q

MI causing bradyarrythmias

A

Inferior - AV node ischaemia

30
Q

Post-MI ST elevation persistance + LV failure

A

LV aneurysm

31
Q

LV aneurysm complication

A

Clot formation => stroke

32
Q

Post-MI Mitral regurgitation cause

A

Posterio-inferior MI - papillary muscle rupture

33
Q

Post-MI early-to-mid systolic murmur

A

Mitral regurgitation

34
Q

LV free wall rupture - presentation and %

A 
Cardiac tamponade (raised JVP, pulsus paradox, diminished HS) 1-2 wks post-MI
3%
35
Q

Ventricular septal defect - presentation and %

A

Pan systolic murmur + HF

1-2% in 1st week

36
Q

Dressler’s syndrome presentation + management

A

Fever, pleuritic pain, pericardial effusion + raised ESR

NSAIDs

RM - Cardio Summary (1 decks)

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