Mplus Cardiology Flashcards
In Chad’ scoring, if it is 0 score
What is the management?
No anticoagulants
In Chad’s scoring, if the score is 1
What is the management?
No antioplatelets or no anticoagulants
In Chad’s scoring, if the score is 2
What is the management?
Anticoagulant needed
1Severe chest pain Radiating to the back
Wide mediastinum
Diastolic murmur
ST segment elevation
Clinical features: thoracic or abdominal pain which is sharp, tearing or ripping
Aortic Dissection
What is contraindicated in Aortic Dissection?
Thrombolysis like Alteplase
Because of the risk of bleeding
What is the treatment for AORTIC Dissection?
Morpihe - for pain relief
BETA blocker - to keep the systolic BP <120 mmHg
Urgent TOE - to confirm the diagnosis of AD
Non-specific T wave inversion
Elevated triponin level
What is this ?
NSTEMI
What is the management for NSTEMI?
ASPIRIN AND CLOPIDOGREL
What is the treatment of Inferior Stemi/ Acute Segment Deviation?
Repercussion Therapy with Fibrinolytics or Urgent PCI
Pleural effusion. Chest pain
This happened 2 - 3 wks after the onset of Myocardial Infarction.
Dressler’s Syndrome
What is the treatment of Dressler’s Syndrome?
Aspirin
Tall T waves
Prolong Pr
What is the diagnosis and treatment?
HYPERKALEMIA
tx: Calcium Gluconate 10%
- infused 2-3 mins with cardiac monitoring lasting for 30 mins
What are the causes of elevated Troponin?
Renal failure
Myocarditis
Atrial Fibrillation
Pulmonary thromboembolism
What does not elevate Troponin level?
Bradyaarythmias
What is the treatment for Infectious Endocarditis?
A B lactam Gentamicin
Elevated JVP or Kussmaul’s sign
Other signs include:
Massive hepatosplenomegaly
Ascites
Peripheral edema
Constrictive Pericarditis
What are the dual antiplatelet drugs and how long should it be taken ?
Ticagrelor
Prasugel
Clopidogrel
12 months
Crackles in the lungs
Wheezes
Poor weight gain
CARDIAC heart Failure
Diastolic murmur
HYPERTROPHIC CARDIOMYOPATHY
Most effective prevention for CVD and premature cardiac death?
Quit smoking
What are the low risk of developing coronary heart disease?
LSL <4 mmol/L
Triglyceride <2 mmol/L
HDL > 1 mmol/L
Total Cholesterol _ 5.5 mmol/L
What is the nonpharmacologic therapy for coronary heart disease?
DIET AND EXERCISE
Sample case of CVD assessment
Systolic BP of 180 mmHg
And total cholesterol >7.5
What is the Absolute CVD risk for this patient?
> 30%
Patient, male, obese BMI 32
Heavy drinker, smoker
Hypertension and DM type 2
Erectile dysfunction
What is the next management?
Check blood sugar
What are the first line investigations for erectile dysfunction?
Blood glucose
Free testosterone
Thyroid Function
Proactive Levels
Luteinizing Hormone
What is the gold standard for the ST elevation?
CARDIAC CATHETERIZATION
Segmental elevation
II, III and AVF
What is the next management?
Repercussion Therapy
- cardiac catheterization
What are the different types of Cardiac Catheterization?
- PCI
- Angioplasty
- Balloon Angioplasty
What is the second line of treatment for ST segment elevation?
Fibrinolytic Therapy
If patient is being transported to a tertiary coronary rescue unit, while on transit this should be the management
Morphine and Glyceryl Nitrate
What is the most common cause of death in adults < 35 years?
Hypertrophy Cardiomyopathy
What is the treatment for Hypertrophic Cardiomyopathy?
SUBLINGUAL NITROGLYCERIN
After giving sublingual nitroglycerin what is the next step for patients with Hypertrophic Cardiomyopathy?
Refer to Stress Echocardiography
What are the factors that help in predicting prognosis of patients with heart failure ?
Echocardiogram
LAB investigation
Patient’s history
Functional Statins
Except:
JVP
What is the next best management if there is Syncope or episodes of loss of consciousness even if the ECG is normal?
EEG
What is the most appropriate investigation to rule out pulmonary embolism?
V/Q scan
48 cholecystectomy, USG gallstones, general anaesthesia with enditracheal intubation, Co2 gas insufflation, severe sinus bradycardia , atrioventriculat block, cause of the observe intraoperative finding in the patient?
Peritoneal Stretching
Acute onse left sided weakness, increased fatigue, low grade fevers, occasional palpitations, no prior medical conditions , no medications, non-smoker, non alcoholic, s1 and s2 and middiastolic rumble at the apex, lungs clear, left sided weakness kn neurologic examination, hgb 10.2, brain imaging shows small infarcts, transthoracic echocardiography shows mass in the Left atrium. Diagnosis?
Intracardiac tumour
No heart murmurs. Lungs clear , normal sinus rhythm, ecg shoes moderate left atrial enlargement, lvh. Ejection fraction 65%, further work up is most likely to identify in this patient?
Atrial fibrillation
What is the treatment for diastolic heart failure
Diuretics
Dioxin
Vasodilators
80 yo man emerg3ncy strangulated direct hernia. Clopidogrel sustained in acute MI. What is the next best management priort to the surgery?
Give platelets and proceed to surgery
Pulmonary component of S
2 is split.
A2 follows P2 during expiratory phase of respiration.
What is the diagnosis?
Aortic valve stenosis
Copd, bilateral ankle edemea, raised jugular vein pressure , positive hepatojugylat reflux, loud P2, decreased air entry and fine bilateral crackles. What is the diagnosis?
Cor pulmonale
Which of the Ff would form the basis for diagnosis an acute ST segment elevation myocardial Infarction or Stemi?
Chest pain/discomfort, suggestive acute MI in the presence of St segment elevation more than 1 mm in two contagious leads or newly developed LBBB
Which of the following is not an ECG finding associated with dioxin use?
Prolonged qt interval
4 benighted ECg changes associated with therapeutic levels of digoxin
T WAVE CHANGES ASUCH AS FLATTEBIBG OR UVERSIOB
qT interval shortening
Scooped appearance of ST segment with ST segment depression
Increased amplitude of U wave
Echocardiography reveals an ejection fraction of 55%. What is the underlying cause of the murmur?
Papillary muscle dysfunction
Widened mediastinum
Aortic dissection
Most appropriate treatment for widened mediastinum
Give morphine and beta blockers and arrange for TOE
Which one of the following test results indicated a high probability of pulmonary embolus in a particular zone of rhe lung?
Normal chest X Ray, normal ventilation, reduced perfusion
Not a contraindication to thrombolytics use in a patient with ST elevation myocardial infraction
Heavy menstrual bleeding
Which of the Ff best describes the conditions termed as acute coronary syndrome
Unstable angina, non st elevation, kyocardial infarction and St elevation
