notes from quesmed Flashcards
investigations for aortic stenosis
trans thoracic echocardiogram
commonly exertional syncope
hypertension management
1- ACE-I or CCB if afrocaribbean or over 55. ARB is cant tolerate ACE-I
2- combine CCB and ACE-I/ARB
3- thiazide like diuretic
4- if blood potassium <4.5mmol/L add spironolactone if >4.5 increase thiazde like diuretic. or add alpha blocker, beta blocker
treatment for aortic stenosis
transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR).
or medical therapy -symptomatic management of LVF with diuretics and heart failure meds with BB and ACE-I for those who are not suitable for intervention.
all who are symptomatic or ejection fraction <50% or >50% who are active and symptoms when exercising
ABPM targets hypertension
<80 years <135/85
>80 years <145/85
T1DM with end organ damage <130/80
common organisms for IE
staph aureus (common in IV drug users)
strep viridans (poor dentition)
caog neg staph eg staph epidermis (prosthetic valve endocarditis)
strep bovis (colon cancer)
inferior stemi shows in what leads and what artery
II, III, aVF. RCA
anterolateral STEMI shows in what leads and what artery
V1-4. LAD
what else can show ST elevation not MI
pericarditis
management of pericarditis
Idiopathic or Viral Pericarditis
1st line: exercise restriction and NSAIDS (+ PPI) for 1-2 weeks.
2nd line: colchicine (SE: diarrhoea, use in caution in those with renal or hepatic impairment).
3rd line: corticosteroids (for those who cannot tolerate or refractory to NSAIDS).
Bacterial Pericarditis
1st line: IV antibiotics +/- pericardiocentesis if purulent exudate present.
Rare cases - pericardectomy may be performed if adhesions or recurrent tamponade occurs.
Non-Infective Pericarditis
1st line: corticosteroids (due to the risk of reactivation and if infection has been ruled out).
