Vasvular Flashcards
Three characteristics of stable angina
squeazing, crushing sensation in chest
1) precipitated by stress or exercise
2) relieved by rest or nitrates
3) recover lasts less than 15 min
ECG findings in pericarditis
Saddle shaped ST elevation
Systolic ejection murmur
Pulmonary stenosis
Type A vs type B aortic dissection
Type A: ascending aorta or arch
Type B: the rest
Treatment for haemodynamically unstable AF.
Synchronised cardioversion
How does GTN spray work
Forms free NO which increases cGMP in smooth muscle and toner tissues, leading to decreased intracellular calcium and vasodilation
Hypertension levels
140/90 or 135/85
Mid systolic click, late systolic murmur
Mitral prolapse
Medical management of MI pre PCI
MONA Metoclopramide Opiates/oxygen GTN Aspirin Plus antiplatelet
5H and 4T of pulseless cardiac arrest
Hypovolaemia, hypoxia, hydrogen ions (acidosis), hyper/hypokalaemia, hypothermia
Toxins (tricyclics, cocaine), tamponade, tension pneumo, thrombosis
First line medication for 2nd degree block
Atropine
Diastolic murmur, pounding heart when lying on left side. Best heard at right parasternal edge
Aortic regurgitation
Gold standard investigation for unstable angina
Coronary angiography (if GRACE risk >3%) with PCI if indicated
Risks in AF
Stroke, HF. Consider anticoagulation using CHADS.
Medical management of heart failure and effects of medications
Loop diuretics: increase sodium and water excretion in the ascending loop of henle.
ACE inhibitors usually started first, then add a beta blocker.
If intolerant to ACE, can give Angiotensin II blockers instead.
Add an aldosterone antagonist (e.g. spironolactone if needed).
Indications for PCI in MI
Presentation within 12h and PCI can be delivered within 120min of time when fibrinolysis could have been given,
Diastolic murmur, loud P2, pink cheeks
Mitral stenosis
Management of aortic dissection
Type A usually always need surgical repair.
Type B can be conservative management, with fastidious blood pressure control (b blockade, sodium nitroprusside).
Investigations in stable angina
If 1 characteristics, do ecg and check if abnormal. If it is or 2 + characteristics, do ecg and CTPA.
Arteries blocked in: Buttock and hip Thigh Upper 2/3 calf Lower 1/3 calf Foot
Buttock and hip: iliac / aorta Thigh: common femoral Upper 2/3 calf: superficial femoral Lower 1/3 calf: popliteal Foot: tibial/ peroneal
When to reverse anticoagulation in warfarin asymptomatic patient
INR > 8
Mid-late systolic murmur, crescendo decrescendo pattern, slow rising pulse, carotid radiation
Aortic stenosis
What investigations to perform in atrial fibrillation
ECG, cardiac enzymes (exclude MI), Sats to check for shock. If patient is going to have cardio version (synchronised on R wave), a transesophageal echo is required to check for any thrombus which may be dislodged during procedure
Second degree type I and II block and II:I block
Type I: lengthening PR
Type II sudden non progressive lengthening of PR interval and block of QRS complex.
2:1 block is 2 p wave for each QRS
