Heart attack Flashcards
1
Q
Immediate management of MI
A
MONA= morphine, oxygen, nitrates and asprin.
2
Q
?
A
Thrombolysis or primary angioplasty
3
Q
How does pul oedema present on CXR?
A
Bat wing appearance of perihilar shadowing
Kerley B
4
Q
If their BP drops alongside the pul oedema, what would your next steps be?
A
CPAP to push the fluid back into the circulation before you can give any diuretics etc
5
Q
Causes of pulmonary oedema
A
Acute MI Dysrhythmia Valvular heart disease Hypertensive crisis Kidney failure Neurogenic (e.g. stroke) Severe infection Toxins
6
Q
Complications of pulmonary oedema
A
Reduce exercise tolerance Resp failure Dysrhythmias Worsening CCF and MI Organ failure Death
7
Q
What might you see on examination of pulmonary oedema?
A
Sweaty Clammy Audibly bubbly Restless Hypertensive if in cardiogenic shock) If hypotensive, not so godo HR and RR raised Creps in lung fields Abnormal heart sounds Raised JVP Peripheral oedema
8
Q
Investigations for pulmonary oedema
A
Serial ECGs CXR BNPs FBC Renal profile Troponin ABGs ??
9
Q
Acute management
A
ABCD Find and treat cause Sit them up O2 Wide bore IV access? Opiates GTN infusion for Vasodiolation IV frusemide for diuresis Rate or rhythm control for dysrhythmimas NIV
10
Q
Long term management of cardiac related pulmonary oedema
A
ACE inhibitors / ARBs Beta blockers Diuretics Potassium sparing diuretics Cardiac resynchronisation therapy
