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Y1 Cardiovascular > Ischaemic Heart Disease and MI > Flashcards

Ischaemic Heart Disease and MI Flashcards

1
Q

Co-morbidities associated with angina?

A

diabetes, PVD, MI, COPD

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2
Q

Primary prevention for MI is…

A

when there is no history of an MI - trying to prevent happening in first place

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3
Q

Secondary prevention for MI is…

A

when preventing further MIs after a history of having one.or more

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4
Q

GTN side-effects?

A

hypotension, headache

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5
Q

GTNs work as..

A

vasodilators as an NO donor

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6
Q

Calcium antagonists - dihydropyridines - can be given in angina, give some examples…

A

nifedipine, amlodipine

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7
Q

Side effects of CCB such as dihydropyridines?

A

ankle oedema

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8
Q

examples of b-blockers used in angina?

A

atenolol, bisoprolol

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9
Q

K-ATP channel openers used in angina example

A

nicorandil

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10
Q

Side-effects of rate limiting CCB in angina?

A

ankle oedema, heart block

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11
Q

CCB should not be used with?

A

b-blockers

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12
Q

long acting nitrates include?

A

isosorbide mononitrate

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13
Q

side effect of long acting nitrates include:

A

nitrate tolerance

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14
Q

Ivabradine acts on the ______ ______ to slow heart rate

A

funny current

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15
Q

Problem of ivabradine…

A

reduces exercise tolerance due to HR being unable to go above ~80bpm

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16
Q

T wave inversions are a sign of…

A

ischaemia

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17
Q

Extra drug used in NSTEMI treatment - not MONA+C

A

fondaparinux

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18
Q

Fondaparinux is…

A

Factor Xa inhibitor

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19
Q

Why are anti-coagulants given in AF?

A

to stop clots in L.atrium and thus prevent stroke or MI

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20
Q

typical anti-coagulants used in AF?

A

warfarin, rivaroxiban and apixiban

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21
Q

Spironolactone is…

A

an aldosterone antagonist

22
Q

Side effect of spironolactone

A

hyperkalaemia

23
Q

Ivabradine works in AF - true or false?

A

false

24
Q

If a patient’s renal function is reduced on ACEIs, what is the first step?

A

stop and rechallenge at a lower dose - then consider other treatment if still intolerant

25
Q

Mechanical complications of an Acute MI

A

VSD, MR (mitral regurgitation), Rupture

26
Q

Angina can be described as…

A

pressing, squeezing, heaviness, a weight - on exertion, with stress, cold wind, after meals

27
Q

intercostal pain can be described as…

A

dull, knifelike, stabbing, no pattern, at rest

28
Q

DDx of chest pain

A

angina, MI, GI, musculoskeletal, pericarditis, pleuritic pain, pulmonary embolus, dissection of the aorta

29
Q

Different methods of determining CHD

A

Exercise ECG, Perfusion Imaging, CT angiography, angiography

30
Q

Pro of exercise ECG

A

cheap, reproducible, risk stratification

31
Q

cons of exercise ECG

A

poor diagnostic accuracy, submaximal test

32
Q

Pros of perfusion imaging

A

non-invasive, pharmacological stress in less mobile patients, more precision than ETT, risk stratification

33
Q

Cons of perfusion imaging

A

radiation, false positives and false negatives

34
Q

Pros of CT angiography

A

non-invasive, anatomical data and risk stratification

35
Q

Cons of CT angiography

A

radiation, less precise than angiography, cost

36
Q

Pros of angiography

A

gold standard, anatomical and risk stratification, follow on angioplasty

37
Q

Cons of angiography

A

risk of death or stroke, radiation, contrast - renal dysfunction, rash, nausea

38
Q

Pharmacological management of CHD

A

aspirin, b-blockers, statin, ACEI

39
Q

What type of diagnosis is angina?

A

clinical - based off history and exam

40
Q

Chronic stable angina is a sign of what sort of coronary plaque?

A

fixed stenosis with demand led ischaemia

41
Q

Acute coronary syndromes include…

A

unstable angina, NSTEMI, STEMI

42
Q

Unstable angina is a sign of what sort of coronary plaque?

A

waxing and waning stenosis with increased ischaemia

43
Q

Possible ECG changes in STEMI

A

ST elevation, T wave inversion, Q waves, new onset LBBB, >1mm ST elevation in 2 adjacent limb leads, >2mm ST elevation in at least 2 contiguous precordial leads

44
Q

Other markers for diagnosis of MI

A

creatinine kinase, troponin

45
Q

MONA+C stands for…

A

morphine, oxygen, nitrates, aspirin and clopidogrel

46
Q

Aim for treatment of MI

A

PCI (STEMI) and Thrombolysis or either

47
Q

Door to balloon time in MI

A

90 mins

48
Q

Arrhythmic complications of MI

A

V Fib

49
Q

Structural complications of MI

A

Cardiac rupture, VSD, Mitral valve regurge, papillary, LV aneurysm, systemic emboli, Inflammation, Acute pericarditis, Dresslers syndrome

50
Q

Functional Complications of MI

A

acute VFailure, chronic cardiac failure, cardiogenic shock

Y1 Cardiovascular (12 decks)

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