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Cardiovascular System > Management > Flashcards

Management Flashcards

1
Q

When a patient has a confirmed STEMI what are the two different treatment options that you have?

A

Either a PCI or thrombolytic treatment

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2
Q

When you have confirmed a STEMI why do you need to act fast?

A

Because “time is muscle” and the quicker you unblock the vessel the less muscle you will lose

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3
Q

What is the time frame for thrombolytics to be used in?

A

6-12 hours, but ideally within 90 minutes

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4
Q

Apart from MIs when else can you use thrombolytics?

A

For certain types of strokes and pulmonary embulous

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5
Q

How does a PCI work?

A

It maintains coronary artery potency by inflating a stent in the vessel, which allows for blood flow to be restored

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6
Q

Why is a PCI preferred to using thrombolytics?

A

When you carry out a PCI you have a decreased risk of bleeding and reinfarction

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7
Q

What do we use to remember the secondary medications used to manage cardiovascular disease?

A

The 6 A’s

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8
Q

What are the 6 A’s?

A

~Aspirin, 75 mg once a day
~Another anti-platelet for 12 months
~Atrovastatin 80 mg once a day
~ACE inhibitor such as ramipril
~Atenolol or another Beta blocker, at the highest dose tolerable until max dose
~Aldosterone antagonist eg epleronone, for patients with clinical heart failure

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9
Q

When prescribing secondary medication for CVD what are the aims of the therapy?

A

~Decrease oxygen demand
~Increase oxygen supply

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10
Q

What is the acronym that you follow when you know that your patient is having a NSTEMI?

A

BATMAN
B-Beta blockers (unless contradicted)
A-Aspirin, 300mg loading dosse
T- Ticagrelor, 180mg loading dose OR 300mg clopidogrel loading dose
M- Morphine
A- Anticoagulants, low molecular weight heparin at treatment dose
N- Nitrates, GTN spray, to relieve coronary artery spasms

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11
Q

What is the additional step to the BATMAN treatment for patients?

A

Give the patients oxygen if their sats are below 95%

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12
Q

What is the acronym that you would use if your patient is a confirmed STEMI?

A

MONAC
M-Morphine
O-Oxygen
N-Nitrates
A-Aspirin
C-Cyclizine or metaclopramide (antisickness)

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13
Q

What can we prescribe to reduce the chances of pericarditis reoccurring?

A

Colchicine

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14
Q

If a patient with pericarditis is not improving after NSAIDs what can we prescribe them?

A

Corticosteroids

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15
Q

How do we treat myocarditis usually?

A

The same as conventional heart failure

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16
Q

How can we treat patients with dangerous atheroma?

A

We can stent them, via an angioplasty

17
Q

What should be the first line drugs to treat the symptoms of heart failure?

A

Loop diuretics

18
Q

What are the main 3 drug classes that we use to treat heart failure?

A

Diuretics, ACE inhibitors and beta blockers

19
Q

Before starting and patient on diuretics and before increasing their dose what should you check?

A

Their serum electrolyte levels and renal function

20
Q

What can we use Digoxin to treat?

A

Heart Failure

21
Q

When prescribing Digoxin why is it important that we monitor the plasma levels of the drug?

A

Because it has a small therapeutic window and so it can become toxin in the body very quickly

22
Q

What criteria does the patient have to meet to be prescribe Entresto?

A

~LVEF less than 35%
~ NYHA classification of between 2 and 4
~ Already on a stable does of an ACE inhibitor or ARBs

23
Q

When a patient presents with acute heart failure what are the 4 things you should immediately do?

A

~ Give IV nitrates
~ Give IV diuretics
~ Give oxygen
~ Monitor and restrict the fluid intake

24
Q

When a patient presents with heart failure symptoms what are the further investigations that you should be carrying out?

A

12 lead ECG, Blood (FBC, U and Es, LFTs and BNP), ECHO and a chest X-ray

25
Q

What is the classification system that we use to categorise what stage of heart failure a patient has?

A

New York Heart Association (NYHA) Classification

26
Q

If a patient presents with HF symptoms and has a BNP of more than 400 and a previous MI history what are the next steps in their treatment?

A

Urgent referral and they should have an ECHO within at least 2 weeks

27
Q

If a patient presents with HF symptoms and has a BNP of between 100-400 and no previous MI history what are the next steps in their treatment?

A

They should be referred to the specialist team and should have an ECHO within 6 weeks

28
Q

When treating HF what are the 2 things that we are aiming to do?

A
  1. Provide symptom relief
  2. Improve the prognosis for the patient

Cardiovascular System (8 decks)

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