Ischaemic heart disease Flashcards
List the modifiable risk factors for IHD?
- Smoking
- Hypertension
- Obesity
- Diabetes
- Inactivity
- Hypercholesterolaemia
List the non-modifiable risk factors for IHD?
- Family hx
- Age
- Sex (male)
List the common presenting symptoms of IHD?
- Ischaemic chest pain
- SOB
- Palpitations
- Syncope
- Lethargy
What is the WHO definition of MI?
MI requires at least 2 of the following 3 features:
• Symptoms of myocardial ischaemia
• Elevation of cardiac markers (troponin or CK)
• Typical ECG pattern involving development of Q waves, ST segment changes or T wave changes
What is the definition of acute coronary syndrome?
Refers to a spectrum of clinical presentations from MI, unstable angina to angina
What are the ECG changes in a STEMI?
- ST segment elevation
- Q waves in leads next to ST-elevation
- may get T wave inversions
How is IHD managed in hospital?
- reperfusion
- O2
- IV morphine
- aspirin
- IV heparin or subcutaneous clexane
- IV GTN
- beta blockers and ACE inhibitors after
What are the common complications of MI?
- ischaemic (infarct extension, angina)
- mechanical (valve, aneurysm, rupture, failure)
- arrhythmic
- embolic (CNS, periphery)
- inflammatory (pericarditis)
What are the lateral leads?
- I, (aVL), V5 and V6
What are the inferior leads?
II, III and aVF
What are the anterior/septal leads?
V1, V2, V3, V4
What are the posterior leads?
V7-9 (placed on the back in special circumstances)
When is percutaneous coronary intervention indicated?
- skilled lab available
- door to balloon time t be thrombolysed
- late presentation
- diagnosis of STEMI in doubt
When is fibrinolysis preferred?
- early presentation
- invasive strategy not an option
- delay to lab (e.g. location in country town)
