IHD & HF

Question 1

IHD umbrella term includes

Answer 1

stable angina
unstable angina
MI
sudden cardiac death

Question 2

possible ECG changes in IHD

Answer 2

L axis deviation
LBBB (angina / MI)
STEMI / NTEMI
Q waves (prev MI)
Nb. often normal in stable disease

Question 3

ADRs of GTN

Answer 3

headaches

hypotension > falls / syncope

Question 4

what to prescribe while awaiting IHD investigations

Answer 4

GTN
safety netting
consider aspirin
(X other pharmacological management - stress test will not show pathology otherwise)

Question 5

IHD investigations

Answer 5

specialist chest pain referral
ECG
RF investigations: lipid profile, HbA1c, FBC + TFTs

Question 6

IHD management

Answer 6

lifestyle modifications
anti-platelet: aspirin, clopidogrel
symptomatic relief: BXs, CCBs
lipid lowering drugs: statins, ezetimibe

Question 7

complications of IHD

Answer 7

stroke 
MI
HF
PAD
sudden cardiac death

Question 8

unstable angina presentation

Answer 8

chest pain (at rest / upon exertion)
normal troponin + Non-ST elevation / T wave inversion / normal

Question 9

NTEMI presentation

Answer 9

chest pain

^ troponin + Non-ST elevation / T wave inversion / normal

Question 10

STEMI presentation

Answer 10

persistent chest pain
^^ troponin + ST elevation in 2 or more of the same zone / new LBBB
^ CK

Question 11

Chronic HF investigations

Answer 11

NT-proBNP
ECG
causes: CXR, bloods, urinalysis
Transthoracic echo (grading: EF to guide management)

Question 12

diuretic indicated for HF

Answer 12

furosemide 40 mg OD

v if v renal function - 20mg OD

Question 13

when should hs-TnI be taken

Answer 13

on admission

1 hour after admission

Question 14

ST elevation in RV4

Answer 14

RV infarction

Question 15

ST depression in V1-4

Answer 15

true posterior MI

treat as a STEMI