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- Y6 Respiratory > MedEd - Chest pain > Flashcards

MedEd - Chest pain Flashcards

1
Q

decubitus angina

A

symptoms occur when lying down

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2
Q

prinzmetal angina

A

symptoms caused by coronary vasospasm

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3
Q

coronary syndrome x

A

symptoms of angina but with normal exercise tolerance and normal coronary angiograms

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4
Q

conservative stable angina treatment

A

stop smoking
lose weight
exercise

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5
Q

medical treatment for angina

A

anti-anginals (BB/CCB)
symptomatic (GTN spray)
risk factor reduction (aspirin/statins/ACEi)

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6
Q

ACS (3)

A

STEMI
NSTEMI
Unstable angina

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7
Q

Differences between ACS types

A

STEMI/NSTEMI -
Unstable angina pectoris - chest pain at rest due to ischaemia without cardiac injury
BUT on presentation they all seem the same.

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8
Q

Who may not get ACS symptoms?

A

Elderly
Diabetic
Women

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9
Q

Investigations for ACS

A

ECG - STEMI - hyperacute T waves,, ST elevation, new-onset LBBB. UAP/NSTEMI - ST depression, T wave inversion

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10
Q

Which artery supplied AV node

A

Right coronary artery - so you get complete heart block

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11
Q

General ACS management

A 
MONABAS(H)
morphine 
oxygen 
nitrates
antiplatelets (aspirin AND clopidogrel)
HOME:
beta-blockers 
ACE inhibitors 
statins
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12
Q

aim of STEMI treatment

A

PCI
fibrinolysis
–> coronary reperfusion

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13
Q

NSTEMI/UAP management

A

immediate -
aspirin
fondaparinux - because you are causing turbulent flow
UFH -

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14
Q

Clopidogrel?

A

P2Y12 inhibitor of ADP receptor

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15
Q

complications of ACS

A 
DARTH VADER 
death 
arrhythmia 
rupture 
tamponate 
heart failure 
valve disease 
aneurists 
dressler's
embolism
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16
Q

anticoagulants vs antiplatelets

A 
venous (e.g.DVT, PE) - usually stasiss so activation of coagulation factors so ANTICOAGULANTS
arterial thrombosis (e.g. MI, stroke) - mostly caused by vessel wall injury so ANTIPLATELETS
17
Q

warfarin and ACS?

A

Do not use because it initally is PRO-THROMBOTIC

18
Q

pericarditis

A

inflammation of pericardium

19
Q

causes of pericarditis

A

idiopathic
Infective (e.g. Coxsackie B - common in young chest pain)
Connective tissue disease (e.g. sarcoidosis )
Dressler syndrome - (pericarditis that happens 2-10 weeks after MI)
Malignancy

20
Q

Dressler syndrome

A

pericarditis 2-10weeks after MI
antibodies against cardiomyocyte antigens against which they should not have been exposed to in the first place - AUTOIMMUNE

21
Q

symptoms

A 
sharp, central chest pain 
pleuritis 
relieved by sitting forward 
fever/flu-like symptoms (if viral)
pericardial pleural rub
22
Q

pericarditis ECG

A

widespread saddle-shaped ST elevation, has a characteristic dip - NOT MI because the

23
Q

Beck’s triad

A

CARDIAC TAMPONADE triad:
muffled heart sounds
raised JVP
low BP

24
Q

AF causes

A 
pneumonia 
PE
hyperthyroid
IHD
alcohol 
pericarditis
25
Q

AF symptoms

A

palpitations
syncope
symptoms of underlying causes
irregularly irregular pulse

26
Q

AF ECG

A

absent P-waves

irregularly irregular

27
Q

DC cardioversion vs defibrillation

A

DC cardioversion - monitors electric conduction of heart and delivers shock at a specific time
defibrillation - random shock that is hoped to re

28
Q

AF management

A

rhythm control - <48hrs since onset of AF: DC cardioversion, or chemical cardioversion (flecainide [contraindicated in IHD] or amiodarone). If >48hrs then anticoag for 3-4weeks beforecardioversion

stroke risk stratification - CHADSVASC score used

rate control - verapamil, digoxin, beta-blockers

29
Q

supraventricular cardioversion

A

regular, narrow complex tachycardia with no p waves and a supraventricular origin
symptoms: palpitations, syncope, dyspnoea, chest discomfort

30
Q

types of SVT

A

AVRT

AVNRT

31
Q

Investigations for SVT

A

during tachy - regular,

32
Q

AVRT ECG

A

“delta wave” - slurred upstroke of QRS complex

33
Q

SVT treatment

A
  1. Are they haemodynamically stable?
    NO - synchronised DC
    YES - step 2
  2. Vagal maneouvres - e.g. Valsalva, cold water if they work stop, if not …
  3. .Adenosine 6mg - warn patients because it stops your heart for a while
  4. Adenosine 12mg
34
Q

Who do you not use adenosine in ?

A

asthmatics

Use ramipril instead

35
Q

syncope definition

A

hypoperfusion to the brain causing LOC

36
Q

differential diagnosis of syncope

A

vasovagal - increased vagal discharge causing a drop in BP and HR. Can be percipitated by situations . May feel sweaty/pale before collapse
arrhythmia - can lead to low-output state; palpitations before collapse
outflow obstruction
postural hypotension

37
Q

HOCM features (4)

A

jerky carotid pulse
double apex beat
ejection systolic murmur
FH

38
Q

syncopal and non-syncopal causes of fainting

A

Syncopal - vertebrobasillar insufficiency, subclavian steal syndrome, aortic dissection
Non-syncopal - intoxicatoin , head trauma, metabolic, epileptic seizures

- Y6 Respiratory (23 decks)

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