Myocardial Ischaemia

Question 1

What is myocardial ischaemia

Answer 1

Athreloscrelosis blocking blood and oxygen to heart

Question 2

What are the 2 types of Myocardial ischaemia

Answer 2

• Stable Angina
• Acute Coronary Syndromes
  (unstable angina, NSTEMI, STEMI)

Question 3

What is the Initial Treatment for Stable angina

Answer 3

Glyceryl Trinitrate
(emergency if after 3rd dose didnt work)

Question 4

What is the long term prevention of stable angina: 1st Line

Answer 4

BB / RL-CCB

Question 5

What is the long term prevention of stable angina: 2nd Line

Answer 5

BB + CCB

Question 6

What is the long term prevention of stable angina: 3rd Line

Answer 6

ADD:
long acting nitrate / Nicorandil / Ivabradine / Ranolazine

Question 7

How to reduce developing tolerance to Nitrates

Answer 7

• Doses designed to have time off nitrate (2nd dose given 8 hours after not 120
• Patches they should be left off for 8 to 12 hours of the day

Question 8

What are signs of acute coronary syndromes

Answer 8

• chest pain longer than 15 mins
• pain radiating to neck, jaw, arms or back

Question 9

Of all the coronary syndromes, which ones exhibit high troponin levels

Answer 9

• STEMI
• NSTEMI

Question 10

What is the management for suspected Acute coronary syndrome
MONA

Answer 10

M morphine
O oxygen
N nitrate
A aspirin