Treatment Coronary Artery Disease Flashcards
What nmemonic is usefull for coronary artery disease treatment
MONA BASCH
What does MONA BASCH mean?
?Morphine Oxygen Nitro Asa 321 BetaBlocker ACEi Statin Heparin* Clopidogrel**
3 signs of angina
- substernak
- worse w exertion
- improved w ntg
classification of angina according to number of symptoms
typical= 3/3
atypical=2/3
no angina 0-1/3
what to do when positive troponins
Terapeutic Heparin and Clopidogrel load “both stabilize the thrombus”
then get ready for the cath
what to do with a high-risk patient, w angina but without STE nor biochemical changes?
Terapeutic Heparin and Clopidogrel load “both stabilize the thrombus”
then get ready for the cath
On the onset of angina, If there is very low risk that the patient has myocardial infarction, what would be the anticoagulant management?
profilactic heparin for DVT
no cropidogrel
When not to use nitro
In right sided infracts (II, III and aVF w STE) because NTG reduces preload and the RV is preload dependant
Pt with Angina but no STE nor Troponin I E. Next step of management
LMWH no Clopi Troponin q6h x 3 d 12 lead q6h x 3 telemetry strest test ** if low risk
stress test basically makes Dx of
a) acute coronary Sx
b) coronary artery disease
B
indication of a CABG (coronary artery bypass graft)
> =3 vessel block
or big vessel, Left main stem equivalent. CABG is an open heart surgery
catheterization laboratory treatments if
1-2 vessels blocked
>=3 vessels blocked
1-2 :stent 3 cabg and medical management same for all BB+ACEi+ Dual Antiplt therapy: ASA81 + Clopido75 High Potency Statin
what do you mean w
High Potency Statin
half or max dose of atorva
40-80mg
rosuva 20-40
when to do tPA
when transportation time to get to PCI (o sea cath lab) >60 min
