general/larger cardio problems

Question 1

respiratory arrest

Answer 1

• Increasing FiO2
• Treating anaemia – give more Hb
• Increase heart rate with atropine or B-stimulant if bradycardia
• IV fluid, raise legs – improves preload

Question 2

chronic heart failure

Answer 2

1) Loop diuretic [Furesomide] – for pulmonary oedema
2) ACEi + B-Blocker
a. ARB if ACEi intolerant
b. If intolerant to ACEi & ARB → Hydralazine + nitrate
3) Add ivabradine or digoxin

Question 3

acute heart failure

Answer 3

In acute heart failure:
a) Sit up
b) Oxygen
c) IV furosemide
d) IV morphine

Question 4

STEMI/NSTEMI

Answer 4

M - morphine
O – Oxygen if hypoxic
N – Nitrates [GTN]
A – Aspirin (anti-platelet)
+
C – Clopidegrol / Ticagrelor (anti-platelet)
H – Heparin (anti-coagulant)
A – Ace inhibitor (Lisinopril)
B – B-blocker (Atenolol)
PCI in 90 minutes or Thrombolysis

Question 5

stable angina

Answer 5

1) GTN for rapid relief of symptoms + aspirin (secondary prevention)
2) Primary prevention: B-blocker (Atenolol) or CCB
(dihydropyridine – amlodipine)
a. If not tolerated:
i. Long acting nitrate (isosorbide mononitrate)
ii. Nicorandil – K
+ channel activator
iii. Ivabradine - HCN
iv. Ranolazine – inhibits late Na+ current
3) Switch or add CCB and B-blocker
4) Surgery – PCI or CABG

Question 6

hyperlipidaemia

Answer 6

Lipid lowering drugs:
- Statins – used in high cholesterol
- Fibrates – used in high triglyceride
Bile acid binding resins [Colestyramine, colesipol] - inhibit cholesterol absorption
- Promote bile salt excretion meaning more cholesterol converted to bile salts

Question 7

pericarditis

Answer 7

self-limiting so analgesia is all that’s needed