HF and stable angina Flashcards
Where is brain natriuretic peptide secreted from?
cardiac ventricles in repsonse to increased stress
adverse effects of BB
Beta blockers: Bradycardia, hypotension, fatigue, dizziness
adverse effects of ACei
Hyperkalaemia, renal impairment, dry cough, lightheadedness, fatigue, GI disturbances, angioedema
adverse effects of spironolactone
Hyperkalaemia, renal impairment, gynaecomastia, breast tenderness/hair growth in women, changes in libido
adverse effects of furosemide
Hypotension, hypoatraemia/kalaemia,
adverse effects of hydraliazine or nitrates
Headache, palpitation, flushing
adverse effects of hydraliazine or nitrates
Headache, palpitation, flushing
advserse effects of digoxin( only improves morbitdy worsens mortality)
Dizziness, blurred vision, GI disturbances
pharmacolgical mangement in HR
ACEi and BB ( ARB instead of ACEi and then hydralize if neiter of them)
furosemide or bumetanide - to imrpove symptoms but not mortality
after that nroamlly class 3 or 4
spironolcatone or eplerenone
hydralazine for afro
ivabradine - imparied ef
digoxin for if combined with AF
in tachycardias after vagal manouveres adenosine is given what happens if the patient is asthmatic
give verapamil
delta wave and short PR interval seen in
WPW
A 44-year-old female asthmatic patient presents to A&E after complaining of palpitations and shortness of breath. An ECG is performed which shows a supra-ventricular tachycardia of 180 beats per minute. Due to the rapid heart rate, it is not possible to identify the exact cause of the arrhythmia.
What is the most appropriate pharmacological agent to slow down the rate to be able to identify the arrhythmia?
verapamil 2.5-5mg
absent arm pulses in young woman
Takayasu’s arteritis is a rare form of larger artery vasculitis mainly affecting young women. The classic sign in absent arm pulses. It does not present with acute chest pain
A 23 year old male presents to his general practitioner with a 2 day history of intermittent central, sternal chest pain that feels worse when he wakes up and takes a inspires deeply. He is otherwise fit and well with no relevant past medical history and is a regular gym goer taking no regular medications.
On examination his observations are all within normal range and he has normal heart sounds, a clear chest and a soft and non tender abdomen.
What is the most likely cause of this patient’s chest pain?
Costochondritis
Costochondritis is inflammation of the costal cartilage causing pain on respiration. It can be extremely painful and can often be misdiagnosed as a heart attack, however in this young man with no other past medical history or risk factors for cardiac disease it is vanishingly unlikely to be caused by cardiac related issues. The exact aetiology of costocondritis is not well understood however it is thought to be often post-viral. Treatment consists of NSAIDs and adequate hydration with other analgesia as required
pain on respiration think
costocondritis - hydrate and pain relief
