step 3 5 Flashcards
what is EPS
dystonia, akathisia, or parkinsonism
by far leading cause of death in our country
coronary artery disease
biggest RF for CAD
diabetes
most common cause of chest pain that is not cardiac in etiology
GERD
best test for evaluating EF
nuclear ventriculogram
mortality affect of ACEis/ARBs in ACS
only with LV dysfunction or systolic dysfunction
ACS interventions that lower mortality
aspirin, thrombolytics, primary angioplasty, metoprolol, statins, clopidogrel, ACE/ARBs ( if EF low)
NSTEMI vs. STEMI
No lytics in NSTEMI, and anticoagulation is used
cardioselective betablockers
metoprolol, atenolol
how to determine if someone needs a CABG
significant changes on stress testing → coronary angiography → determine if candidate for CABG
better graft for CABG
internal mammary artery (10 yrs) vs saphenous vein (5 yrs)
CABG indications
- 3 coronary vessels with 70 percent stenosis
- left main coronary artery stenosis 50-70 percent
- 2 vessels in a diabetic
- 2 or 3 vessels with low EF
CAD management
ASA
Metoprolol
Statin with LDL goal <70
ACSVD cut-off for statin
7.5%
why do we use statins?
proven mortality benefit
PCSK9 inhibitors
evolocumab, alirocumab
use of PCSK9 inhibitors
severe hyperlipidemia (familial hypercolesterolemia) not responsive to statins
new cardiac drugs
Ivabradine
Sacubitril/valsartan
both shown to have mortality benefit.
HFpEF management
beta blockers and diuretics (verify)
meds with mortality benefit in CHF
ACE/ARB, betablocker, spironolactone
severe HFrEF management
IF EF <35% → ICD
IF EF <35% + QRS > 120 → biventricular pacemaker (IE cardiac resynchronization therapy)
consider life vest
→ think about discontinuing betablocker (may be exacerbating fluid overload/pulmonary edema).
absolute contraindication to beta blocker
symptomatic bradycardia
