Treatment (Conservative, Medical, Surgical) Flashcards
Conservative treatment of Heart failure
Smoking cessation advice
Weight loss
Promotion of healthy diet and exercise
Medical treatment of HF
ABCD DS
Angiotensin converting enzyme (ACE) inhibitors
Beta-blockers
Candesartan (Angiotensin receptor blocker)
Digoxin
Diuretics
Spironolactone
What are only 2 Beta blockers licensed in UK
Bisoprolol
Carvedilol
When would you use Candsartan and what is it?
Angiotensin Receptor Blocker
Use if person intolerant to ACE inhibitors
What is Digoxin
Cardaic glycoside
Example of diuretic used to treat HF
Furosemide
What is Spironolactone
Aldosterone Receptor Antagonist
Surgical treatment of HF
Heart transplantation
Conservative Treatment of Myocardial Infarction (MI)
Lifestyle measures such as smoking cessation and increased exercise
Immediate Medical treatment of Myocardial Infarction (MI)
MONA B for immediate management: Morphine Oxygen (if hypoxic) Nitrates (glyceryl trinitrate - GTN) Anticoagulants - Beta blockers (if no contraindication)
Example of Nitrate spray
Glyceryl Trinitrate
Example of Anticoagulants for immediate management
Aspirin and an Antiemetic
Medical treatment of Myocardial Infarction on discharge
On discharge all patients should be prescribed: Aspirin ACE inhibitor Beta-blocker (if no CIs) Statin
If contraindication for beta blockers is present, what could be prescribed instead
Calcium channel blocker
Surgical treatment of MI
Reperfusion with PCI if STEMI
PCI may also be used in NSTEMI, but if NSTEMI patients are not having immediate PCI
Drugs to prevent blood clots
PCI = Percutaneous Coronary Intervention
Surgical treatment of MI - what can be given to prevent blood clots (2 options) and via what route of admin
Fondaparinux - Factor Xa inhibitor
Low Molecular Weight Heparin (LMWH)
Subcutaneously
Conservative treatment of Angina Pectoris
Modify risk factors, e.g:
- Control cholestrol
- Control diabetes
- Smoking cessation advice
- Weight loss
- Increase exercise
- Control hypertension
Medical treatment of Angina Pectoris
Nitrates (Glyceryl Trinitrate spray) ABC: Aspirin Beta-blockers Ca2+ antagonists (especially if BB is CI) K+ channel agonist
Side effects of GTN spray
Headache
Hypertension
When are Beta-Blockers contra-indicated
Asthma
Chronic Obstructive Pulmonary Disease
Examples of a K+ channel activator
Nicorandil
2 Surgical treatment options of Angina Pectoris
Percutaneous Transluminal Coronary Angioplasty
OR
Coronary Artery Bypass Graft (CABG)
Conservative Treatment of Infective Endocarditis
Maintain good oral hygiene
General/All treatment of Infective Endocarditis depends on causative agent
Main Medical treatment of Infective Endocarditis
Benzylpenicillin and Gentamicin
Medical treatment of Infective Endocarditis for Staphlococci
Flucloxacillin
Gentamicin
Medical treatment of Infective Endocarditis for Streptococci
Benzylpenicillin
Amoxicillin
Medical treatment of Infective Endocarditis for Aspergillus
Miconazole
Conservative treatment of Aortic Stenosis
Manage cardiovascular risk factors e.g. smoking cessation
Medical treatment of Aortic Stenosis
Manage cardiovascular risk factors e.g. control BP
Surgical treatment of Aortic Stenosis
Valve replacement
Conservative treatment of Aortic regurgitation
Manage cardiovascular risk factors e.g. smoking cessation
Medical treatment of Aortic regurgitation
Manage heart failure by following NICE guidelines
Surgical treatment of Aortic regurgitation
Valve replacement
Conservative treatment of Mitral Stenosis or Regurgitation
Manage CVS risk factors such as smoking cessation
Medical treatment of Mitral Stenosis or Regurgitation
Manage AF and heart failure by following NICE guidelines
Surgical treatment of Mitral Stenosis
Valve replacement
Surgical treatment of Mitral Regurgitation
Valve repair preferred
Valve replacement may interfere with function of papillary muscles
Conservative treatment of hypertension
Lifestyle advice including: smoking cessation encouraging weight loss decreases alcohol consumption salt restricted diet
Surgical treatment of hypertension (when?)
Surgical excision (if related to cause)
Medical treatment of hypertension in <55 year old
4 steps
A or C
A+C
A+C+D
Refer for add-on therapy
A = ACE inhibitor or ARB C = Calcium channel blocker D = thiazide-type diuretic
What could be added on at end of hypertension medical treatment
Spironolactone
Alpha-blocker
Beta-blocker
Side effect of Spironolactone
Hyperkalemia
Medical treatment of hypertension in >55 year old or black patients
(4 steps)
D
A+D
A+C+D
Refer for add-on therapy
A = ACE inhibitor or ARB C = Calcium channel blocker D = thiazide-type diuretic
Conservative treatment of atrial fibrillation
Patient education and management of cardiovascular risk factors
e.g. smoking cessation and decreased alcohol intake
Medical treatment of atrial fibrillation
Treat underlying cause and:
Restore rate
Restore rhythm
Anticoagulant
Medical treatment of atrial fibrillation - how would you restore rate
Beta-blocker
Calcium antagonist
Digoxin
Amiodarone
Medical treatment of atrial fibrillation - how would you restore rhythm
Beta-blocker
Cardioversion
Amiodarone
Medical treatment of atrial fibrillation - anticoagulant given
Warfarin
Apixaban
Dabigatran
Rivaroxaban