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Cardiovascular > Identifying and Treating MI > Flashcards

Identifying and Treating MI Flashcards

1
Q

Define hypoxia.

A

Lack of oxygen (any cause).

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2
Q

What is ischaemia?

A
  • Restriction in blod supply to the tissues, causing lack of oxygen.
  • Reversible.
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3
Q

What is infarction?

A

Tissue death from obstruction of blood supply to a tissue / organ.

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4
Q

What could chest pain be attributed to when considering a differential diagnosis?

A
  • Cardiovascular - thromboembolic
  • Lung - infection
  • GI - inflammation
  • MSK - traumatic
  • Skin - malignancy
  • Psychiatric
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5
Q

What are the possible cardiovascular causes of chest pain?

A
  • MI
  • Aortic dissection
  • Pericarditis
  • Myocarditis
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6
Q

What are the possible causes of chest pain related to the lungs?

A
  • Pneumonia
  • Pneumothorax
  • PE
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7
Q

What are the possible causes of chest pain related to the GI tract?

A
  • Cholecystitis
  • GORD
  • Peptic ulcer disease
  • Boerhaave’s syndrome
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8
Q

What are the possible causes of chest pain related to the MSK system?

A
  • Rib fracture
  • Muscle strain
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9
Q

What are the possible causes of chest pain related to the skin?

A
  • Shingles
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10
Q

What are the possible psychological-related causes of chest pain?

A
  • Anxiety
  • Panic disorder
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11
Q

What are the potential cardiac complications of MI?

A
  • Heart failure
  • Arrhythmias
  • Cardiogenic shock
  • Rupture
    • Papillary muscle -> acute valve insuffciency
    • Left ventricular free wall
    • Ventricular septum
  • Pericarditis
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12
Q

What are the potential iatrogenic complications of MI?

A
  • Bleeding
  • Trauma to vessels from angiography
    • Vessel dissection
  • Stent thrombosis
  • Surgical complications
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13
Q

What other kinds of complications can accompany MI (bigger picture)?

A
  • Psychosocial
  • Financial
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14
Q

Define heart failure.

A

Heart muscle pumping ineffectively

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15
Q

Define arrhythmias.

A

Disruption of normal electrical conduction

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16
Q

Define cardiogenic shock.

A

Muscle pumping ineffectively

17
Q

Describe cardiac rupture.

A
  • Soft necrotic tissue tears easily
    • Papillary muscle -> acute valve insufficiency
    • Left ventricular free wall
    • Ventricular septum
18
Q

What causes pericarditis?

A

Cardiac complication of MI. It is an autoimmune response.

19
Q

Give the mnemonic for the complications associated with MI.

A

Death

Arrhythmia

Rupture

Tamponade

Heart failure

Valve disease

Aneurysm (ventricular)

Dressler’s syndrome

Embolism

Recurrence

20
Q

Describe the use of ECG in patients presenting with chest pain.

A

PERFORM AN ECG ASAP IN PATIENTS PRESENTING WITH ACUTE CHEST PAIN.

21
Q

What are the associated symptoms of cardiac disease?

And of differentials in patients presenting with acute chest pain?

A
  • Of cardiac disease:
    • Sweating
    • Nausea and vomitting
    • Dizziness
    • Shortness of breath
  • Thinking about differentials:
    • Fever
    • Cough
    • Loss of apetite
    • Shortness of breath
    • Leg pain / numbness
22
Q

What are the risk factors for cardiac disease?

A
  • Modifiable
    • Smoking
      • Quantify in pack years
    • Blood pressure
      • Diagnosed when?
      • Treated or untreated?
    • Cholesterol
    • Diabetes
    • Weight / diet / lifestyle
  • Non-modifiable
    • ​Family history
      • 55 years for men
      • 65 years for women
    • Sex
    • Ethnicity
  • Think about the risk factors for other differentials:
    • ​PE
    • Pneumothorax
    • Aortic dissection
23
Q

What questions do you need to ask when taking a drug history from a patient presenting with chest pain?

A
  • Prescribed:
    • Regular - why?
    • New - why?
    • Changes - why?
  • Over the counter
    • NSAIDs
  • Herbal
    • Interactions with prescribed medications
  • Illicit
    • Cocaine, cannaboids - frequency, route of administration
  • Adherence - do you manage to take your medication as they’ve been prescribed?
  • Do you ever miss doses? If so, why?
24
Q

Describe the examination of a patient presenting with acute chest pain.

A
  • End of the bed
    • Well of unwell?
    • In pain or comfortable?
    • Sweaty?
    • Vomitting?
    • Pale?
    • Short of breath?
  • Vital signs
    • HR
    • RR
    • BP
    • SpO2
    • Temperature
  • Systems examination:
    • Cardiovascular system
    • Respiratory system
    • GI system
      • / - neurological examination
25
Q

What are the investiations you would do in a patient presenting with acute chest pain?

A
  • Bedside:
    • ECG
  • Lab:
    • hsTroponin
  • Radiology:
    • Chest X-ray
    • CT coronary angiogram
26
Q

Describe the supportive management of a patient presenting with acute MI.

A
  • Sublingual GTN
  • Morphine
  • Oxygen if SpO2 is <94%
27
Q

Describe the specific management of a patient presenting with acute MI.

A
  • Aspirin 300mg PO
  • Other anti-platelet agent
28
Q

Describe the disposition management of a patient presenting with acute MI.

A
  • Transfer to specialist centre for PCI if achievable within 120 minutes of diagnosis.
  • Thrombolysis if PCI is not possible in the time frame.

Cardiovascular (12 decks)

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